Clin Nephrol. 2022 Feb;97(2):103-110. doi: 10.5414/CN110514.
The pathogenesis of primary focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) remains unknown to date. Some circulating permeability factors are being discussed. This work assessed molecule candidates for permeability in serum samples of patients with nephrotic syndrome (NS).
41 patients with chronic glomerulonephritis (CGN) were included in our study. 17 patients had FSGS, 7 patients had MCD, 5 patients had membranoproliferative glomerulonephritis (MPGN), 6 patients had IgA nephropathy, and 6 patients had membranous nephropathy (MN). The laboratory data were compared with the clinical and histological features of nephritis. Serum levels of plasminogen activator urokinase receptor (uPAR) and cardiotrophin-like cytokine factor 1 (CLCF-1)were measured by ELISA.
The serum levels of uPAR were higher in FSGS patients before treatment than in patients with other morphological forms (MCD, IgA nephropathy, MN, and MPGN). The levels of uPAR in serum did not correlate with daily proteinuria, serum creatinine/eGFR, arterial hypertension, the number of sclerosed glomeruli, or tubulointerstitial fibrosis. No correlations were found between the levels of CLCF-1 in serum and creatinine levels/glomerular filtration rate, the percentage of sclerosed glomeruli, or the severity of tubulointerstitial fibrosis. There were no significant differences between the histological variants of nephritis. However, we found correlations between CLCF-1 levels and proteinuria and lipid levels.
The data indicate an increase in the serum uPAR levels of FSGS before treatment. CLCF-1 levels in serum do not depend on histological forms of CGN, kidney function, or immunosuppressive treatment, but they correlate with proteinuria and serum lipids in patients with NS.
原发性局灶节段性肾小球硬化症(FSGS)和微小病变性肾病(MCD)的发病机制目前尚不清楚。一些循环通透性因子正在被讨论。本研究评估了肾病综合征(NS)患者血清样本中通透性相关的候选分子。
共纳入 41 例慢性肾小球肾炎(CGN)患者,其中 17 例为 FSGS,7 例为 MCD,5 例为膜增殖性肾小球肾炎(MPGN),6 例为 IgA 肾病,6 例为膜性肾病(MN)。实验室数据与肾炎的临床和组织学特征进行了比较。酶联免疫吸附试验(ELISA)检测血清中尿激酶型纤溶酶原激活物受体(uPAR)和心营养素样细胞因子 1(CLCF-1)的水平。
FSGS 患者治疗前的血清 uPAR 水平高于其他形态学形式(MCD、IgA 肾病、MN 和 MPGN)的患者。血清 uPAR 水平与每日蛋白尿、血清肌酐/肾小球滤过率(eGFR)、动脉高血压、硬化肾小球数量或肾小管间质纤维化之间无相关性。血清 CLCF-1 水平与肌酐水平/肾小球滤过率、硬化肾小球百分比或肾小管间质纤维化严重程度之间也无相关性。肾炎的组织学变异之间无显著差异。然而,我们发现 CLCF-1 水平与蛋白尿和脂质水平之间存在相关性。
数据表明治疗前 FSGS 患者的血清 uPAR 水平升高。血清 CLCF-1 水平不依赖于 CGN 的组织学形式、肾功能或免疫抑制治疗,但与 NS 患者的蛋白尿和血清脂质相关。