Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, People's Republic of China.
Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, People's Republic of China.
Ren Fail. 2020 Nov;42(1):539-546. doi: 10.1080/0886022X.2020.1772295.
Mucosal immunity plays an important role in the pathogenesis of IgA nephropathy (IgAN). This study aimed to investigate if infection of (), a common bacteria in the gastrointestinal tract, associated with IgAN. This study included 261 patients with IgAN and 46 healthy controls. Clinical information and plasma samples were collected from patients and healthy controls. infection was confirmed by western blot. Plasma IgA1 and galactose-deficient IgA1 (Gd-IgA1) levels were detected by specific enzyme-linked immunosorbent assay. Total infection rates showed no statistical differences between IgAN patients and healthy controls, but the infection rates of type I in IgAN patients were significantly higher than those in healthy controls (44.4 vs. 28.3%, = 0.040). Compared with uninfected patients, the systolic blood pressure, 24-h proteinuria, and blood urea nitrogen levels were significantly higher in patients with infection (126.0 ± 15.5 vs. 119.6 ± 14.5 mmHg, = 0.010; 1.8 ± 2.7 vs. 1.2 ± 1.4 g/24h, = 0.013; 7.9 ± 5.4 vs. 6.7 ± 3.9 μmol/L, = 0.042), especially in patients with type I infection (126.5 ± 15.4 vs. 119.6 ± 14.5 mmHg, = 0.002; 1.9 ± 2.9 vs. 1.2 ± 1.4 g/24 h, = 0.033; 8.1 ± 5.6 vs. 6.7 ± 3.9 μmol/L, = 0.041). Similarly, patients with IgAN and type I infection showed higher plasma Gd-IgA1 levels than uninfected patients (5.5 ± 2.2 vs. 4.5 ± 2.2 μg/mL, = 0.037). Virulent type I infection is more common in patients with IgAN. Patients with IgAN and type I infection showed lower renal function and higher underglycosylation of plasma IgA1.
黏膜免疫在 IgA 肾病 (IgAN) 的发病机制中起重要作用。本研究旨在探讨胃肠道常见细菌 是否与 IgAN 相关。本研究纳入了 261 例 IgAN 患者和 46 例健康对照者。采集患者和健康对照者的临床资料和血浆样本。采用 Western blot 法证实 是否感染。采用特异性酶联免疫吸附试验检测血浆 IgA1 和半乳糖缺乏 IgA1 (Gd-IgA1) 水平。IgAN 患者和健康对照者的总 感染率无统计学差异,但 IgAN 患者的 I 型 感染率显著高于健康对照者(44.4%比 28.3%,=0.040)。与未感染者相比, 感染者的收缩压、24 小时尿蛋白和血尿素氮水平显著升高(126.0±15.5 比 119.6±14.5mmHg,=0.010;1.8±2.7 比 1.2±1.4g/24h,=0.013;7.9±5.4 比 6.7±3.9μmol/L,=0.042),尤其是 I 型感染者(126.5±15.4 比 119.6±14.5mmHg,=0.002;1.9±2.9 比 1.2±1.4g/24h,=0.033;8.1±5.6 比 6.7±3.9μmol/L,=0.041)。同样,IgAN 合并 I 型 感染者的血浆 Gd-IgA1 水平也高于未感染者(5.5±2.2 比 4.5±2.2μg/mL,=0.037)。具有毒力的 I 型 感染在 IgAN 患者中更为常见。IgAN 合并 I 型 感染者的肾功能较低,血浆 IgA1 低聚糖修饰程度较高。
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