Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2021 Oct;41(5):880-887. doi: 10.1007/s11596-021-2409-z. Epub 2021 Oct 1.
Diagnosis of immunoglobulin A nephropathy (IgAN) requires the evaluation of renal biopsy specimens. However, renal biopsy is an invasive procedure and is not frequently performed for various reasons. Thus, recognized noninvasive biomarkers for predicting IgAN progression are urgently needed.
In the present study, we included 86 IgAN patients with renal biopsy from June 2015 to May 2016 and had their plasma interleukin-7 (IL-7) level measured with ELISA. The association between the plasma IL-7 level and clinico-pathological characteristics was analyzed. Immunohistochemical staining was used to assay the in situ expression of IL-7 in vivo. Western blotting was performed to examine the production of extracellular matrix, p-mTOR and the markers of autophagy under the treatment of IL-7 after TGF-β1 stimulation in renal tubular epithelial cells.
IL-7 was significantly decreased in patients with IgAN compared to healthy subjects (2.3077 vs. 8.6294 pg/mL, P<0.0001). There was a significant difference in the plasma IL-7 level between tubular atrophy/interstitial fibrosis T0 and T2 classes (P=0.0064). A lower plasma IL-7 value in patients at the time of biopsy indicated a poor renal outcome. In addition, IL-7 was over-expressed in renal tubular epithelial cells and significantly attenuated transforming growth factor βl-induced extracellular matrix production by suppression of cellular autophagy via activation of mTOR1 signaling.
These results suggested that IL-7 might be a noninvasive biomarker for predicating IgAN. It protected renal proximal tubular epithelial cells from cellular fibrosis by inhibiting autophagy via mTORl signaling.
诊断免疫球蛋白 A 肾病(IgAN)需要评估肾活检标本。然而,由于各种原因,肾活检是一种有创性的操作,并不经常进行。因此,迫切需要可识别的预测 IgAN 进展的非侵入性生物标志物。
本研究纳入了 2015 年 6 月至 2016 年 5 月期间进行肾活检的 86 例 IgAN 患者,并通过 ELISA 检测其血浆白细胞介素-7(IL-7)水平。分析了血浆 IL-7 水平与临床病理特征之间的关系。采用免疫组化染色法检测体内 IL-7 的原位表达。Western blot 法检测转化生长因子-β1(TGF-β1)刺激后,IL-7 处理对肾小管上皮细胞细胞外基质、p-mTOR 和自噬标志物的产生。
与健康对照组相比,IgAN 患者的 IL-7 水平显著降低(2.3077 与 8.6294 pg/mL,P<0.0001)。肾小管萎缩/间质纤维化 T0 期和 T2 期患者的血浆 IL-7 水平存在显著差异(P=0.0064)。患者活检时的血浆 IL-7 值较低提示肾脏预后不良。此外,IL-7 在肾小管上皮细胞中过表达,并通过激活 mTOR1 信号抑制细胞自噬,显著减弱转化生长因子-β1 诱导的细胞外基质产生。
这些结果表明,IL-7 可能是预测 IgAN 的非侵入性生物标志物。它通过 mTOR1 信号抑制自噬来保护肾近端小管上皮细胞免受细胞纤维化。