Renal Division, Department of Internal Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
Nephrology (Carlton). 2009 Dec;14(8):728-34. doi: 10.1111/j.1440-1797.2009.01109.x.
Proteinuria varies in different glomerular diseases and even the same one. Podocin, encoded by gene NPHS2, is important in maintaining the integrity of slit diaphragm structure and avoiding proteinuria. Presently, case-control association studies were performed to investigate the genetic effect of variants in NPHS2 in a mass proteinuric glomerulopathy, minimal change disease (MCD) at first, followed by further investigation in immunoglobulin A nephropathy (IgAN).
At first, 214 northern Chinese patients with MCD and 493 geographically-matched healthy controls were enrolled. Variants of the NPHS2 were screened. SNP-2 (rs3829795:C>T, c.-670C>T) and SNP-5 (rs3738423:C>T, c.288C>T) were selected as tagging single nucleotide polymorphisms (SNP) and haplotypes were reconstructed. Association was analyzed in MCD patients. Then, the identified SNP site was analyzed in IgAN patients with mild histological changes (Haas subclass I and II).
The C allele and CC genotype frequencies at the SNP-2 site, as well as the frequency of haplotype CC, were significantly lower in MCD patients than in healthy controls. Furthermore, they were also associated with the degree of proteinuria in MCD patients. But in IgAN patients, no such association was identified.
The study suggested the polymorphism and haplotype of NPHS2 gene were associated with the genetic susceptibility and also the degree of proteinuria to MCD. Proteinuria in MCD and IgAN might occur through different mechanisms.
蛋白尿在不同的肾小球疾病中存在差异,甚至在同一疾病中也存在差异。足细胞蛋白(podocin)由 NPHS2 基因编码,对维持裂孔隔膜结构的完整性和避免蛋白尿具有重要作用。目前,已经进行了病例对照关联研究,以调查 NPHS2 基因变异在大量蛋白尿性肾小球病(微小病变病,MCD)中的遗传效应,首先在 MCD 中进行,然后在免疫球蛋白 A 肾病(IgAN)中进一步研究。
首先,纳入了 214 名中国北方 MCD 患者和 493 名地理匹配的健康对照者,筛选 NPHS2 基因的变异。选择 SNP-2(rs3829795:C>T,c.-670C>T)和 SNP-5(rs3738423:C>T,c.288C>T)作为标签单核苷酸多态性(SNP),并重建单体型。在 MCD 患者中分析其关联性。然后,在具有轻度组织学改变(哈斯分类 I 和 II)的 IgAN 患者中分析鉴定出的 SNP 位点。
SNP-2 位点的 C 等位基因和 CC 基因型频率以及 CC 单体型频率在 MCD 患者中明显低于健康对照组。此外,它们还与 MCD 患者的蛋白尿程度相关。然而,在 IgAN 患者中,未发现这种关联。
研究表明 NPHS2 基因的多态性和单体型与 MCD 的遗传易感性和蛋白尿程度有关。MCD 和 IgAN 的蛋白尿可能通过不同的机制发生。