The Expression And Clinical Significance Of Autophagy Ralated Genes Atg3 And Atg5 In Peripheral Blood Mononuclear Cells Of Patients With Newly Diagnosed IgA Nephropathy Before Treatment

Objective:To study the relationship between the expression of autophagy-related gene Atg3 and Atg5 in peripheral blood mononuclearcell(PBMC)and pathology of the patients with newly diagnosed IgA nephropathy before treatment.Methods:From July 2017 to May 2018,28 patients newly diagnosed with IgA nephropathy before treatment by pathological biopsy in the department of nephrology of the First Affiliated Hospital of Guangxi Medical University and the Second Affiliated Hospital of Guangxi Medical University were selected as the experimental group,and 32 normal healthy subjects during the same period were selected as the control group.Fasting peripheral blood samples were collected,clinical data,laboratory data and pathological data of both groups were collected.Real-time quantitative PCR(RT-PCR)was used to detected the expression levels of Atg3 and Atg5 mRNA in peripheral blood mononuclear cells of both groups.SP immunohistochemistry was further used to observe the expression of Atg3 and Atg5 proteins in PBMC of the two groups.The relationship between the clinical date,experimental biochemical data,renal pathology and expression levels in Atg3 and Atg5 mRNA in patients with newly diagnosed IgA nephropathy before treatment were analyzed.Results:1.The expression of Atg3 mRNA in PBMC of patients with newly diagnosed IgA nephropathy before treatment(n=28)was significantly higher than that of the control group(n=32)(P<0.05),while that was no significant difference in Atg5 mRNA(P>0.05).2.The positive rate of Atg3 protein expression in PBMC of patients with newly diagnosed IgA nephropathy before treatment(80%)was higher than that of the control group(40%),and the positive cell rate of Atg5 protein expression in PBMC of patients with newly diagnosed IgA nephropathy before treatment(80%)was higher than the control group(60%)by using fluorescence microscope too.3.The incidence of upper respiratory tract infection,hematuria,edema,hypertension,waist and back pain was no significant difference between the Atg3 high-expression group and low expression group(P>0.05).Serum IgA,24-hour urine protein,creatinine,CCR,urea,uric acid,blood HCO3~-,low-density lipoprotein,high-density lipoprotein,erythrocyte sedimentation,white blood cells was no significant difference between the Atg3 high-expression group and low expression group(P>0.05).4.LEE grade and nephropathy pathological scores(AI,CI)was no significantly different between the Atg3 high-expression group and low expression group(P>0.05).5.The incidence of upper respiration tract infecion in Atg5 mRNA high-expression group(n=14)was significantly lower than Atg5 mRNA low-expression group(n=14)(P<0.05).It’s also that serum IgA,HCO3-and erythrocyte sedimentation rate(ESR)was significantly lower in Atg5 mRNA high-expression group(P<0.05).6.LEE grade and nephropathy pathological scores(AI,CI)was no significantly different between the Atg5 high-expression group and low expression group(P>0.05).Conclusions:1.The expression of autophagy related gene Atg3 mRNA in PBMC of patients with newly developed IgA nephropathy before treatment was up-regulated,which might affect the development of IgA nephropathy by regulating autophagy activity.2.The high expression of autophagy-related gene Atg5 mRNA might be associated with a decrease in the incidence of upper respiratory tract infection in patients with newly diagnosed IgA nephropathy before treatment.3.Up-expression of autophagy-related gene Atg5 mRNA might be associated with decreasing serum IgA and ESR,affecting renal tubular reabsorption of HCO3~-.