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血管紧张素 II 型受体抗体在肾小球疾病中的作用。

Angiotensin II Type 2 Receptor Antibodies in Glomerular Diseases.

机构信息

Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.

CellTrend Gmbh, Luckenwalde, Germany.

出版信息

Arch Immunol Ther Exp (Warsz). 2024 Aug 19;72(1). doi: 10.2478/aite-2024-0017. eCollection 2024 Jan 1.

Abstract

We evaluated the concentration of AT2R antibodies in 136 patients with primary and secondary glomerular diseases: membranous nephropathy (n = 18), focal and segmental glomerulosclerosis (n = 25), systemic lupus erythematosus (n = 17), immunoglobulin A (IgA) nephropathy (n = 14), mesangial (non-IgA) proliferative nephropathy (n = 6), c-ANCA vasculitis (n = 40), perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) vasculitis (n = 16), and compared it with a healthy control group (22 patients). Serum creatinine levels, proteinuria, serum albumin, and total protein concentrations were prospectively recorded for 2 years. The mean levels of AT2R antibodies in the lupus nephropathy group were significantly higher compared to the control group, 64.12 ± 26.95 units/mL and 9.72 ± 11.88 units/mL, respectively. There was no association between this level and the clinical course of the disease. The AT2R levels in other kinds of glomerular disease were no different from the control group. We found significant correlations between AT1R and AT2R in patients with membranous nephropathy (r = 0.66), IgA nephropathy (r = 0.61), and c-ANCA vasculitis (r = 0.63). Levels of AT2R antibodies in systemic lupus erythematosus are higher compared to other types of glomerulonephritis, vasculitis, and a healthy control group. Levels of AT2R antibodies correlate with AT1R antibodies in the groups of patients with membranous nephropathy, IgA nephropathy, and c-ANCA vasculitis. These kinds of AT2R antibodies have a stimulative effect on AT2R, but we have not found the influence of these antibodies on the clinical course of glomerular diseases.

摘要

我们评估了 136 例原发性和继发性肾小球疾病患者的 AT2R 抗体浓度:膜性肾病(n = 18)、局灶节段性肾小球硬化(n = 25)、系统性红斑狼疮(n = 17)、免疫球蛋白 A(IgA)肾病(n = 14)、系膜(非 IgA)增生性肾病(n = 6)、c-ANCA 血管炎(n = 40)、核周抗中性粒细胞胞质抗体(p-ANCA)血管炎(n = 16),并将其与健康对照组(22 例)进行比较。前瞻性记录了 2 年的血清肌酐水平、蛋白尿、血清白蛋白和总蛋白浓度。狼疮性肾炎组 AT2R 抗体的平均水平明显高于对照组,分别为 64.12 ± 26.95 单位/ml 和 9.72 ± 11.88 单位/ml。该水平与疾病的临床病程无关。其他类型肾小球疾病的 AT2R 水平与对照组无差异。我们发现膜性肾病(r = 0.66)、IgA 肾病(r = 0.61)和 c-ANCA 血管炎(r = 0.63)患者的 AT1R 和 AT2R 之间存在显著相关性。与其他类型的肾小球肾炎、血管炎和健康对照组相比,系统性红斑狼疮患者的 AT2R 抗体水平更高。膜性肾病、IgA 肾病和 c-ANCA 血管炎患者组的 AT2R 抗体水平与 AT1R 抗体相关。这些类型的 AT2R 抗体对 AT2R 有刺激作用,但我们尚未发现这些抗体对肾小球疾病临床病程的影响。

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