Medical School of Chinese PLA, Beijing, China.
Department of Nephrology, The First Medical Center, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China.
Front Immunol. 2021 Jun 30;12:683913. doi: 10.3389/fimmu.2021.683913. eCollection 2021.
IgA nephropathy is the most prevalent primary glomerulonephritis worldwide, with identical immunopathological characteristics caused by multiple etiologies as well as influenced by geographical and ethnical factors. To elucidate the role of immunologic and inflammatory mechanisms in the susceptibility to IgA nephropathy, we explored single nucleotide polymorphisms of related molecules in the immune pathways. We searched the PubMed database for studies that involved all gene variants of molecules in the 20 immunologic and inflammatory pathways selected from the Kyoto Encyclopedia of Genes and Genomes database. The odds ratios with their corresponding 95% confidence intervals in six genetic models (allele model, dominant model, homozygote model, heterozygote model, overdominant model, and recessive model) were summarized using fixed or random effect models. Subgroup analysis was conducted based on different ethnicities with generalized odds ratios. Heterogeneity was evaluated using the Q and I tests. Begg's funnel plot and Egger's linear regression test were used to evaluating possible publication bias among the included studies, and sensitivity analysis was used to test the stability of the overall results. A total of 45 studies met our selection criteria and eight related genetic association studies were retrieved, including 320 single-nucleotide polymorphisms from 20 candidate pathways, ranging from 2000 to 2021. A total of 28,994 healthy people 20,600 IgA nephropathy patients were enrolled. Upon meta-analyzed results that (rs1800469, rs1982073, rs1800471), (rs1143627), (rs1946518), and (rs5743557) showed effect with or without ethnicity difference. And 10 variants presented stable and robust related to IgA nephropathy. This research showed that genetic variants are related to the immunologic and inflammatory effects of IgA nephropathy pathogenesis. The meta-analysis results supported the previous researches, and may help deepen the understanding of pathogenesis and explore new targets for IgA nephropathy-specific immunotherapy.
IgA 肾病是全球最常见的原发性肾小球肾炎,具有相同的免疫病理学特征,由多种病因引起,并受地理和种族因素的影响。为了阐明免疫和炎症机制在 IgA 肾病易感性中的作用,我们探索了免疫途径中相关分子的单核苷酸多态性。我们在 PubMed 数据库中搜索了涉及从京都基因与基因组百科全书数据库中选择的 20 个免疫和炎症途径中分子的所有基因变异的研究。使用固定或随机效应模型总结了六个遗传模型(等位基因模型、显性模型、纯合子模型、杂合子模型、超显性模型和隐性模型)的优势比及其相应的 95%置信区间。基于不同的种族进行亚组分析,汇总广义优势比。使用 Q 和 I 检验评估异质性。使用 Begg 漏斗图和 Egger 线性回归检验评估纳入研究中可能存在的发表偏倚,并使用敏感性分析测试总体结果的稳定性。共有 45 项研究符合我们的选择标准,检索到 8 项相关的遗传关联研究,包括来自 20 个候选途径的 320 个单核苷酸多态性,时间范围从 2000 年到 2021 年。共纳入 28994 名健康人,20600 名 IgA 肾病患者。Meta 分析结果显示,(rs1800469、rs1982073、rs1800471)、(rs1143627)、(rs1946518)和(rs5743557)具有或不具有种族差异的效应。10 个变体与 IgA 肾病具有稳定而强大的相关性。这项研究表明,遗传变异与 IgA 肾病发病机制的免疫和炎症作用有关。荟萃分析结果支持了之前的研究,并可能有助于加深对发病机制的理解,探索 IgA 肾病特异性免疫治疗的新靶点。