The Expression And Significance Of Cd146 In Renal Tissue And Peripheral Blood Of Iga Nephropathy

ObjectiveIgA nephropathy(IgA nephrophathy,IgAN)is one of our common glomerulo-nephritis, to detect the adhesion molecules CD 146 in 50 cases of IgA nephropathy in renal tissue and peripheral blood with molecular biology and molecular immunology and pathology techniques. To clarify the molecular characteristics of CD 146 with the relationship between IgA nephropathy and to discuss the possible mechanisms of the CD146 in the pathogenesis of IgA nephropathy by correlation analysis with kidney tissue and clinical, laboratory findings and provide a strong basis on treatment and prognosis of IgA nephropathy.Methodswe analyzed fifty patients that have been made a definite diagnosis to IgA nephropathy by renal biopsy and clinical data from November 2008 to March 2009 in urology department of Jinnan Military General Hospital. There were 32 male and 18 females, mean age 32.32±9.12 years, mean duration of 18.82±30.26 months. All patients were excluded systemic lupus erythematosus, Hepatitis B associated nephritis, purpura nephritis and tumor caused secondary IgAN, and divided into five levels according to 1982 WHO pathological diagnosis grading standards.Normal control group were 33 healthy subjects patients in our hospital during the same period, there were 16 male and 17 females, mean age 38.42±18.14 years, eight cases of them were healthy kidney donors before renal transplantation. Observed and recorded the clinical parameters before renal biopsy in IgA nephropathy patients. Systolic blood pressure (127.40±20.90), diastolic blood pressure (84.64±15.87), hemoglobin (142.24±22.48),24-hour urine protein (1.10±1.61), serum albumin (39.99±6.99), cholesterol (5.29±2.11), triglycerides (2.53±1.61), immunoglobulin A (2.63±0.83), creatinine (89.68±39.53), blood urea nitrogen (5.34±1.27), serum uric acid (363.43±102.79), etc, and estimate glomerular filtration rate (GFR) with the simplified MDRD formula.IgA nephropathy and normal control group were treated with conventional HE, PAS, MASSON, PASM staining, and IgA,IgG,IgM,C3,Clq,FRA,HBsAg,HBcAg immunofluorescence staining, and, in parallel with two kinds of immunofluorescence:to observed the expression of CD146 by indirect immunofluorescence which labeled by TRITC and FITC in the renal tissue of IgAN. Quantified the glomerular and tubulointerstitial damages by Reference Katafuchi scoring (1998).Detect CD146 expression levels in peripheral blood by flow cytometry. SPSS 13.0 statistical software applications for statistical data handling,analysis, results expressed as x±s, P<0.05 as statistically significant difference.Result1,In the normal control group, no or only weak expression of CD146 in mesangial cells, while in 50 cases of IgA nephropathy,38 cases of renal tissue showed high expression, the positive rate was significantly higher than the normal control group (χ2=9.906, P<0.01), the difference is statistically significant; which 14 cases expression in Mesangial area, intensity was (+) in 6 cases, (++) in 4 cases, (+++)in 4 cases; 9 cases expression in glomerular mesangial areas and capillary loop, intensity was (+) in 5 cases, (++) in 3 cases, (+++) in 1 cases; 15 cases expression in mesangium, capillary loops, and renal tubular epithelial cells intensity was (+) in 8 cases, (++) in 4 cases, (+++)3 cases; there are eight cases of interstitial small artery shows positive expression of CD146.The expression intensity of CD146 in IgA nephropathy and the expression of IgA in renal tissue is closely related (r=0.638,p<0.05).2,CD146 expression in peripheral blood of IgA nephropathy was significantly higher than the control group (6.39±3.25% vs 2.24±1.01%), between the two groups was statistically significant (P<0.01);The expression levels of CD 146 in peripheral blood and IgA nephropathy pathological grade showed a significant positive correlation (r=0.492, p<0.05).3,In the immunofluorescence microscopy, TRITC labeled CD146 showed red fluorescence (wavelength 488nm) and FITC-CD146 showed green fluorescence (wavelength 476nm), the expression of two kinds of fluorescence have a consistent position in IgA nephropathy.4,the expression of CD146 in peripheral blood and clinical pathology data correlation analysis shows that, CD146 has a significant positive correlation with systolic lood pressure, diastolic blood pressure, uric acid,24-hour urinary protein, serum creatinine and so on(p<0.05), and with mesangial proliferation, glomerular sclerosis, crescent formation, inflammatory cell infiltration, tubular atrophy and interstitial fibrosis (p<0.05).Conclusions1,CD146 showed high expression in IgA nephropathy, and basically has the same strength and position with IgA, it may suggest CD146 play an important role in pathogenesis and pathological development of IgA nephropathy.2,IgA nephropathy patients CD146 expression was significantly higher than the normal control group, and showed a significant positive correlation.with IgA nephropathy pathological grade.3,CD146 expression in peripheral blood correlated with the 24-hour urinary protein, serum creatinine, systolic blood pressure, diastolic blood pressure, uric acid, cholesterol, mesangial proliferation, glomerular sclerosis, crescent formation, inflammatory cells infiltration, tubular atrophy and interstitial fibrosis, suggesting that CD146 may reflect the damage of IgA nephropathy as an indicator, while involved in the pathological progress of glomerulosclerosis and interstitial fibrosis and is closely related with the prognosis of IgA nephropathy.