The Relationship Between The Serum Level Of Inflammatory Mediators And Renal Dysfunction In Patients With Aristolochic Acid Nephropathy

ObjectiveIn resent years, more and more patients with pharmacal related interstitial nephritis are found, and the affected rate of aristolochic acid nephropathy (ANN) caused by Chinese herb aristolochic class drugs are elevating, and its mechanism is still unknown. Investigation shows the expression of many inflammatory mediators, for example tumor necrosis factor - a (TNFα) , interleukin -6 (IL - 6 ) , interleukin - 1 (IL - 1) increase both in blood and in local renal in-terstitium in patients with acute interstitial nephritis. So treatments with steroid always have good effect. But, there are not any reports about the effect of inflammatory mediators in ANN. For 36 patients of ANN and 10 healthy volunteers , we determine TNFα, IL - 1, IL - 6 in their blood, and get renal biopsy of 11 ANN to detect the Relationship Between the serum level of inflammatory mediators and renal dysfunction in patients with aristolochic acid nephropathy.Materials and methods1 Clinical materials36 patients of ANN including 26 female and 10 male averaged age 56. 5 11.9, from our hospital between 2004. 6 and 2004. 12. conforms to the diagnose standard of ANN. According to the serum creatinine level (Scr) , they are divided into two groups: Scr <450μmol/l ( nitremia group) 16 patients , Scr > 450μmol/l (renal failure group)20 patients. 10 healthy volunteers including 3 female and 7 male, averaged age 54. 2 ± 11.7. 2 Examination of TNFα, IL - 6,IL-1The level of TNFα,IL -6,IL - 1 in blood are examined by ELISA3 Judgment the level of renal interstitial injuryRenal biopsy in 11 ANN patients are gotten. According to the standard used by Jean - Louis Vanherweghem, the changes include the level of tubuloint-erstitial injury and inflammatory cells aggressive degree. The level of tubuloint-erstitial injury was represented by the scores of tubul atrophy and interstitial fibrosis, and the inflammatory aggressive degree was represented by the scores of lymphocyte permeation.4 Statistical analysisAll data are analyzed by SPSS11. 0, measurement data are expressed with X S and analyzed with t test and linear regression.Results1 The level of TNFα, IL - 6 , IL - 1 between nitremia group and healthy volunteers groupIn nitremia and healthy volunteers group, the mean of TNFa respectively are 46. 3 ±19. 1pg/ml and 7.6 ± 1.8pg/ml , the IL-6 are 119.3 ±42. 1pg/ml and 26.8±8.4pg/ml, IL-1 are 78. 0 ±27pg/ml and 20. 8 ±7. 0pg/ml, the level of TNFα, IL - 6, IL - 1 in nitremia group are higher than that in healthy volunteers group( P <0.05).2 The level of TNFα, IL - 6, IL - 1 between renal failure group and healthy volunteers groupIn renal failure group and healthy volunteers group, the mean of TNFa respectively are 8.5 ±2. 6pg/ml and 7.6 ± 1. 8pg/ml , the IL-6 are 27. 5 ±8. 3pg/ml and 26.8±8.4pg/ml, IL-1 are 27. 8 ±6. 9pg/ml and 20. 8 ±7.0pg/ ml, the level of TNFα, IL - 6, IL - 1 between nitremia group in healthy volunteers group have no significant ( P > 0.05).3 The level of TNFα, IL - 6, IL - 1 between nitremia group and renal failure groupIn nitremia and renal failure group, the mean of TNFa respectively are 46.