Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China.
Iran J Kidney Dis. 2020 Mar;14(2):107-118.
Previous studies have shown that TGF-β1/Smad3 signaling promotes renal fibrosis by inhibiting miR-29. To date, only few studies have reportedon circulating microRNAs in IgA nephropathy (IgAN). However, the plasma expression of miR-29a and its role in patients with IgAN remains unclear. In this study, we attempted to elucidate whether plasma miR-29a expression can be used as a biomarker for monitoring disease states.
For this study, 15 healthy subjects, 36 patients with untreated renal biopsy-proven IgAN, and 79 patients with IgAN, who were under treatment for a period of 1 year on an average, all of whom had similar age and gender distributions, were included. The plasma expression of miR-29a in each group was explored by real-time PCR, and the relationship between miR-29a expression and clinical, pathological, and prognostic indicators of IgAN was further evaluated.
Relative plasma expression of miR-29a in patients with IgAN was significantly lower than that in healthy controls (P < .001), and these changes in plasma miR-29a could be suppressed by treatment (P < .05). Plasma miR-29a was positively correlated with eGFR and negatively correlated with proteinuria and serum creatinine, irrespective of whether or not the patients with IgAN accepted treatment (P < .05). Plasma miR-29a level was negatively correlated with primary pathological parameters such as crescent formation, Lee's and Oxford classification (P < .05). Kaplan-Meier analysis revealed that patients with high plasma expression of miR-29a had better renal function and better response to treatment compared to those with low expression (P < .05).
Plasma miR-29a could be considered as a biological marker that reflects renal damage and function, to predict the progression of IgAN.
之前的研究表明 TGF-β1/Smad3 信号通路通过抑制 miR-29 促进肾纤维化。迄今为止，仅有少数研究报道了 IgA 肾病（IgAN）患者的循环 microRNAs。然而，miR-29a 的血浆表达及其在 IgAN 患者中的作用尚不清楚。在本研究中，我们试图阐明血浆 miR-29a 表达是否可作为监测疾病状态的生物标志物。
本研究纳入了 15 名健康对照者、36 名未经治疗的肾活检证实的 IgAN 患者和 79 名平均接受了 1 年治疗的 IgAN 患者，这些患者在年龄和性别分布上均具有相似性。通过实时 PCR 探索了各组血浆 miR-29a 的表达情况，并进一步评估了 miR-29a 表达与 IgAN 的临床、病理和预后指标之间的关系。
IgAN 患者的相对血浆 miR-29a 表达明显低于健康对照者（P<0.001），并且这些血浆 miR-29a 的变化可被治疗抑制（P<0.05）。无论 IgAN 患者是否接受治疗，血浆 miR-29a 与 eGFR 呈正相关，与蛋白尿和血清肌酐呈负相关（P<0.05）。血浆 miR-29a 水平与新月体形成、Lee 分级和牛津分类等主要病理参数呈负相关（P<0.05）。Kaplan-Meier 分析显示，高血浆 miR-29a 表达的患者与低表达的患者相比，肾功能更好，对治疗的反应更好（P<0.05）。
血浆 miR-29a 可作为反映肾脏损伤和功能的生物标志物，用于预测 IgAN 的进展。
