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S-Fas 尿排泄有助于预测增殖性原发性肾小球肾炎患者的免疫抑制治疗结局。

S-Fas urinary excretion helps to predict the immunosuppressive treatment outcomes in patients with proliferative primary glomerulonephritis.

机构信息

Department of Kidney Transplantation, Medical University of Łódź, Łódź, Poland.

出版信息

J Korean Med Sci. 2013 Oct;28(10):1474-81. doi: 10.3346/jkms.2013.28.10.1474. Epub 2013 Sep 25.

Abstract

Deregulation of soluble apoptosis stimulating fragment (sFas) plays an important role in glomerulonephritis (GN). The study assed the influence of immunosuppressive treatment on serum and urine sFas in patients with proliferative (PGN) and non-proliferative (NPGN) GN, and evaluated the potential of sFas measurements in predicting outcomes. Eighty-four patients with GN (45 males and 39 females) were included. Serum concentration (ng/mL) and urinary excretion (ng/mg of urinary creatinine) of sFas were measured before and after the treatment. After 12 months of therapy with steroids and cyclophosphamide, patients were divided into two subgroups according to the treatment results: Responders (R) and Non-Responders (NR). The sFas urinary excretion was reduced after treatment in both PGN and NPGN (from 17.12 ± 15 to 5.3 ± 4.2, P = 0.008 and from 10.11 ± 6.1 to 3.4 ± 3.0, P = 0.039; respectively) whereas the sFas serum concentration remained unchanged. In PGN, pre-treatment urinary sFas concentration was significantly lower in the Responders than in Non-Responders (2.3 ± 3.1 vs 19.4 ± 14.1, P = 0.003), and was lower still than in both R (P = 0.044) and NR (P = 0.042) subgroups with NPGN. The immunosuppressive treatment reduced sFas urinary excretion in proliferative and non-proliferative GN and results suggest that the lower urinary sFas may be linked with favorable therapy outcomes in patients with PGN.

摘要

可溶性凋亡刺激因子 (sFas) 的失调在肾小球肾炎 (GN) 中起着重要作用。本研究评估了免疫抑制治疗对增生性 (PGN) 和非增生性 (NPGN) GN 患者血清和尿液 sFas 的影响,并评估了 sFas 测量在预测结局中的潜力。纳入 84 名 GN 患者(45 名男性和 39 名女性)。在治疗前后测量 sFas 的血清浓度(ng/mL)和尿液排泄量(尿液肌酐的 ng/mg)。在类固醇和环磷酰胺治疗 12 个月后,根据治疗结果将患者分为两个亚组:应答者 (R) 和无应答者 (NR)。PGN 和 NPGN 患者治疗后尿 sFas 排泄量均减少(从 17.12 ± 15 降至 5.3 ± 4.2,P = 0.008 和从 10.11 ± 6.1 降至 3.4 ± 3.0,P = 0.039;分别),而血清 sFas 浓度保持不变。在 PGN 中,与无应答者(2.3 ± 3.1 比 19.4 ± 14.1,P = 0.003)相比,应答者的治疗前尿 sFas 浓度显著降低,与 NPGN 的 R(P = 0.044)和 NR(P = 0.042)亚组相比仍然更低。免疫抑制治疗可降低增生性和非增生性 GN 中的尿 sFas 排泄量,结果表明,较低的尿 sFas 可能与 PGN 患者的良好治疗结果有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0aa5/3792602/22728eb36743/jkms-28-1474-g001.jpg

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