Il-37Expression In Peripheral Blood Is Correlated With Disease Activity In Patients With Iga Nephropathy

Objective:The IL-37expression was detected in protein levels and mRNA in the peripheral bloodof IgA nephropathy (IgAN) patient which is aimed at to explore the correlation of IL–37inthe development and pathogenesis of IgAN, and we also explored the effect of glucocorticoidfor treatment of the disease. We also investigated the correlation of IL-37and clinicalmanifestations, pathological features and immune response in IgAN patients.Methods:Thirty-two newly diagnosed IgAN patients were seleted as the experimental group fromthe First Hospital of Jilin University between November2014and March2015. Threesubgroups:1. Pre-treatment group almost was32cases with IgAN patients,10cases of thatwas post-treatment group, the patients in treatment group orally took glucocorticoid treatment（1mg/kg.d，2weeks）.2. According to the immunologlobin type, which detected byimmunohistochemistry, the patients classifed into IgA type, IgA+IgM, IgA+IgG type.3.According to the pathological features of kidney tissue, the patients were gruoped crescents,and no crescent group. Other clinical information and laboratory results were collectedincluding the patient’s age, sex, ALB, SCr, BUN, blood routine, plasma ion,24h urinaryprotein,24-h urinary albumin, CRP, and erythrocyte sedimentation rate (ESR). Renalpathological classification was determined based on Lee’s Classfication Criteria. The healthycontrol group was selected from36healthy adult volunteers from the First Bethune Hospitalof Jilin University. Serum IL-37protein levels were measured with enzyme-linkedimmunosorbent assay (ELISA) and IL-37、TLR-9、TGF-β1、PDGF-BB mRNA levels weremeasured by qPCR. SPSS and Prism software were applied to analyze the correlationbetween IL-37and clinical data of IgAN.Results:1. In the32cases of the IgAN patients, the ratio of male to female ratio is1.5:1, whichis between18and58. The renal pathological grading by Lee’s grade revealed that most of the patients are in grade III, and grade I, V less; there are no differences between pathologyicalgrade and the gender or age. Patients in grade V were compared to clinical manifestations, theresults indicated the systolic blood pressure and diastolic blood pressure was statisticallysignificant differences(P <0.05).2. IL-37protein and mRNA levels were significantly higher in IgAN patients comparedto the health controls, the difference is significantly (P <0.001). With the treatment byglucocorticoid for2weeks, the IL-37protein levels and mRNA levels significantly decreasedin IgAN patients, which was statistically significant differences (P <0.05).3. IL-37protein and mRNA levels in immune pathological group A type compared withA+M type and A+G type in IgAN patients significantly increased, which was statisticallysignificant differences (P <0.01).4. IL-37protein and mRNA levels was significantly higher in patients with crescentformation compared to those without no cresent formation, which was statistically significantdifferences (P <0.05).5. The mRNA levels of TLR-9, TGF-β1, PDGF-BB was significantly higher than inpatients with crescent formation compared to no crescent formation patients (P <0.05). Twogroups were significantly higher in the IgAN group compared to the health controls group (P<0.05).6. The IL-37protein and mRNA levels were positively correlated with triglycerides（.r=0.513,P<0.05）. Serum C3was negativly correlated with IL-37protein levels (r=0.425,P <0.05), and IL-37mRNA levels was negativly correlated with C3（r=-0.4744, P<0.05）Conclusions:1. IL-37protein and mRNA levels were increased in serum of patients with IgAN,especially in the patients with crescent formation.2. Glucocorticoid treatment decreased the protein and mRNA levels of IL-37, thisfinding revealed that IL-37may be associated with the pathogenesis of IgAN, and indicatedthat detectin to IL-37may have potential as a novel biomarker for evluating the treatmenteffect of IgAN.3. IL-37expression was correlated with TG and C3, the risks factors of IgAN, indicatingIL-37may reflect the disease severity and progression of IgAN. In summary, IL–37may serve as a novel bimarker for evaluating the disease severity and prognosis of IgAN patients.