The Expression And Significance Of P53 And P21 In Patients With Primary Glomerular Disease

Objective: To analyze the correlation between the expression of p53 and p21 protein in patients with primary glomerular disease and the clinical index(urine protein,serum albumin,serum creatinine,glomerular filtration rate).To investigate the possible mechanism of p53 and p21 in the development of primary glomerular disease.Method: 114 patients with biopsy-proven primary glomerulonephritis(PGN)at The second hospital of Hebei Medical University from March 2016 to December 2016 were collected,including 29 patients with membranous nephropathy(MN),29 patients with IgA nephropathy(IgAN),29 patients with focal segmental glomerulosclerosis(FSGS),27 patients with minimal change disease(MCD).13 patients with glomerular minor lesion(GML)and 14 normal renal tissue adjacent neoplastic lesions were regarded as control group.We conducted immunohistochemical analysis of the presence of p53 and p21 protein concentration to investigate whether there is a correlation between them and clinical Indicators.Results:1.Immunostaining for p53 and p21 was detected in MN,IgAN,FSGS,MCD and control group.p21 and p53 were positive in glomerular mesangial cells,capillary endothelial cells and portion of Crescent,and also positive in tubules and interstitial cells;2.Expression of positive rate of p53(%)was detected in 27.5±9.0%,42.9±10.9%,46.2±20.5%,50.2±22.3% and 21.6±9.9%,respectively,of the patients with MCD,MN,IgAN,FSGS and GML.Compared with the the control group was significantly higher in case group(P<0.05).In case group,p53 were significantly increased from MCD,MN to IgAN,FSGS(P<0.05),and the Immunostaining for p53 had no statistical significance between IgAN and FSGS(P>0.05);3.Expression of positiverate of p21(%)was detected in 33.1±12.2%,47.5±14.7%,53.6±21.7%,66.6±21.7% and 23.7±10.2%,respectively,of the patients with MCD,MN,IgAN,FSGS and GML.Compared with the the control group was significantly higher in case group(P <0.05).In case group,p21 were significantly increased from MCD,MN,IgAN,to FSGS(P<0.05);4.The positive rate of p21 and p53 were positively correlated with Scr,CYSC,β2M,age,systolic blood pressure(SBP),Diastolic pressure(DBP)and 24 hour urine protein(24Upro),negatively correlated with Hb,eGFR and had no statistical significance with cholesterol(CHO),triglyceride(TG)and serum albumin(Salb).Conclusions:1 The expression of p53 and p21 protein were obviously increased in primary glomerular disease and there were differences in the expression of different pathological types,and FSGS was strongest,IgAN,MN group and MCD group decreased gradually.2 p21 and p53 were positive in glomerular mesangial cells,capillary endothelial cells and portion of Crescent,and also positive in tubules and interstitial cells.3 Cyclin p53 and p21 may participate in the pathogenesis of primary glomerular disease by participating in podocyte injury.