Study On The Association Of The Pathological Damage And Clinical Indicators And Transformation Growth Factor Beta 1 And Smad7 Protein In IgA Nephropathy

Study on the Association of the pathological damage and clinical indicators andtransformation growth factor beta 1 and Smad7 protein in IgA nephropathy Objectives: IgA nephropathy (IgAN)was first described in 1968 and is now recognized as the commonest primary glomerolopathy all over the word. But its lesions type is complicated, with the mesangium matrix multiply, fibrosis lesions culminates in the glomerular Sclerosis stage. So a reasonable and scientific kidney tissues classification systems is helpful to compare IgAN renal biopsies and predict clinical results.This paper firstly study 139 patients IgAN renal biopsy specimens which collected before two years ago, and analysis relationships of renal histopathologic classification and renal clinical indicators. Secondly, this paper discusses relationships of the serum IgA concentration, kidney tissues IgA precipitation amount and IgA nephropathy. Finally, observing the expression of transformation growth factor beta 1 and Smad7 proteins in different types of IgA nephropathy kidney tissues, and relationship with IgA immune complex deposition quantity in glomerular, for further research on the pathogenesis of IgA nephropathy and discusses the role of TGF - beta 1 / Smads signaling pathways in IgA nephropathy.Methods:1. Collect clinical data of 139 patients with primary IgA nephropathy .Clinical indicators include age, gender, systolic blood pressure and diastolic blood pressure, and 24 hours albuminuria, creatinine and serum IgA concentration. Calculate estimated glomerular filtration rate (eGFR) and mean arterial pressure (MAP)2. Renal biopsy specimens of 139 patients were trypan-blue and graded, scoring standards reference IgA nephropathy Oxford parting. And observed differences of the clinical index in different pathological parameters and groups.3.Using immune fluorescence and a laser confocal microscopy detects IgA immune complex precipitation amount in different types of IgA nephropathy glomerular. Observe theirs differences in different pathological parameters, and analyze the correlation among the various indicators.4.Observe TGF - beta 1 and smad7 proteins in IgA nephropathy renal tissue by immunohistochemical, and compare the expression of the two proteins in different classification IgA nephropathy and the relationship of precipitation amount of IgA immune complex in the glomerular. Results:1. The difference of clinical indicators in pathologic parameters of IgA nephropathy Uniariate analysis results show: Uniariate analysis results show: except between groups of different endothelial cell hyperplasia (E0/1) outside, the rest of the clinical index between parameters are statistically significant differences (P > 0.05) and have different degree of correlation;There are a statistical significance among 9 common group in clinical index.2. The relationships of the serum IgA concentration, kidney tissues IgA precipitation amount and IgA nephropathyIn different groups of the Oxford pathological parameters , serum IgA concentration have no statistically significant; About IgA immune complex deposition ,only between the mesangium cell hyperplasia (M0 / M1) have statistically significance and positive correlation.Serum IgA concentration and kidney tissues IgA immune complex deposition quantity have no correlation .Among 9 groups, serum IgA concentration have no statistically significant, but kidney tissues IgA immune complex deposition weight difference have statistical significance3. TGF - beta 1 and samd7 protein expression in different types of IgA nephropathy kidney tissues (immunohistochemical) resultsTGF - beta 1 and samd7 proteins expression in mesangial cells cytoplasm and renal tubular epithelial cell cytoplasm (chart3-1). TGF - beta 1 and samd7 proteins expression in kidney tissues have difference statistically among 9 groups(P<0.05).4. The correlation among TGF - beta 1, Smad7 and IgA immune complexTGF - beta 1 protein is positively correlated to glomerular segment sclerosis/balloon adhesion (S) and renal tubular atrophy/interstitial fibrosis (T); Smad7 protein is positively correlated to mesangium cell hyperplasia score (M) .The correlation analysis results show that: In kidney tissues, the expression of TGF - beta 1 and Smad7 protein have positive corelation, and IgA immune complex positively related to precipitation amount, and the two latter have no correlation.Conclusion:1. Four pathological parameters in IgA nephropathy Oxford classification can be accurately reflect the dynamic idex of kidney lesions.2. Serum concentrations of IgA high-low may not be the decisive factor of IgA nephropathy happened, but kidney tissues sedimentary IgA immune complex may play an important role in the excessive accumulation of the glomerular extracellular matrix, and in the glomerular sclerosis process3.IgA immune complex which deposited in the glomerular of IgA nephropathy patients may make the TGF -β1 protein expression higher, TGF -β1 and its signal transduction molecules Smad 7 may participate in the over excessive of extracellular matrix in the glomerular, and played an important role in the process of glomerular sclerosis...