Feng Dan, Wu Boying, Pang Yajiao
Pediatric Department, Affiliated People's Hospital of Ningbo University, Ningbo, China.
Transl Androl Urol. 2020 Oct;9(5):2235-2241. doi: 10.21037/tau-20-1260.
Primary nephrotic syndrome (NS) is a common disease of the urinary system with an unclear pathogenesis. We aimed to detect the levels of urinary exosomal miR-23b-3p, miR-30a-5p, and miR-151-3p in children with primary NS, and to explore their diagnostic value for NS.
A total of 115 patients with NS who were admitted to the hospital from June 2017 to June 2019 were selected as the observation group. According to the disease progression, they were divided into an active group (acute active phase, n=68) and remission group (remission phase, n=47). In all, 50 healthy children were selected as the control group. Levels of urinary exosomal miR-23b-3p, miR-30a-5p, and miR-151-3p of each group in different periods were detected.
The 24-h urine protein, serum albumin (ALB), and serum total cholesterol (TC) levels were significantly higher in the observation group than in the control group (P<0.05), while those in the active group were significantly higher than those in the remission group (P<0.05). The levels of miR-23b-3p and miR-30a-5p were significantly higher in the observation group than in the control group, and significantly higher in the active group than in the remission group (P<0.05). No miR-151-3p was detected in the urinary exosomes of the two groups. After treatment, levels of exosomal miR-23b-3p and miR-30a-5p in the two groups both decreased significantly (P<0.05). Results of receiver operating curve (ROC) curve analysis showed that urinary exosomal miR-23b-3p and miR-30a-5p can be used to identify children with NS and healthy children. The area under the ROC curve (AUC) was 0.711 for miR-23b-3p and 0.844 for miR-30a-5p.
The levels of miR-23b-3p and miR-30a-5p in urinary exosomes of children with NS were significantly higher than those in healthy children, and decreased significantly after treatment, indicating that miR-23b-3p and miR-30a-5p in urinary exosomes are potential indicators for diagnosing the progression of NS and monitoring the treatment effect.
原发性肾病综合征（NS）是泌尿系统的常见疾病，发病机制尚不清楚。我们旨在检测原发性NS患儿尿外泌体中miR-23b-3p、miR-30a-5p和miR-151-3p的水平，并探讨它们对NS的诊断价值。
选取2017年6月至2019年6月期间收治的115例NS患儿作为观察组。根据疾病进展情况，将其分为活动组（急性活动期，n=68）和缓解组（缓解期，n=47）。选取50例健康儿童作为对照组。检测各组不同时期尿外泌体中miR-23b-3p、miR-30a-5p和miR-151-3p的水平。
观察组24小时尿蛋白、血清白蛋白（ALB）和血清总胆固醇（TC）水平显著高于对照组（P<0.05），而活动组显著高于缓解组（P<0.05）。观察组miR-23b-3p和miR-30a-5p水平显著高于对照组，且活动组显著高于缓解组（P<0.05）。两组尿外泌体中均未检测到miR-151-3p。治疗后，两组外泌体miR-23b-3p和miR-30a-5p水平均显著降低（P<0.05）。受试者工作特征曲线（ROC）分析结果显示，尿外泌体miR-23b-3p和miR-30a-5p可用于鉴别NS患儿和健康儿童。miR-23b-3p的ROC曲线下面积（AUC）为0.711，miR-30a-5p为0.844。
NS患儿尿外泌体中miR-23b-3p和miR-30a-5p水平显著高于健康儿童，治疗后显著降低，表明尿外泌体中miR-23b-3p和miR-30a-5p是诊断NS进展和监测治疗效果的潜在指标。
