Expression Of RhoA And Cdc42 In Renal Tissues Of IMN Patients And Its Significance

Objective: Membranous nephropathy(MN)is one of the most common causes of nephrotic syndrome in adults worldwide.The disease is characterized by the presence of glomerular subepithelial immune deposits and diffuse thickening of the basement membrane.According to the causes MN can be divided into idiopathic membranous nephropathy(IMN)and secondary membranous nephropathy(SMN).The pathogenesis of IMN is not fully understand as yet.The patients with SMN may be secondary to a variety of reasons,including infection,tumors,autoimmune disease,drug toxic damage and so on.IMN occurs mostly strike middle-aged and elderly people,and the peak incidence of age is 40 to 50 years old.And the rate of male and female for IMN is 2 to 1,while the adult-child ratio is as high as 26.According to the relevant reports,IMN accounts for about 9.89% of primary glomerular disease in our country.It is important to make the pathogenesis of IMN clear and it will be helpful to its clinical diagnosis and treatment.Glomerular podocytes are highly specialized cells with a complex cytoarchitecture,which play a critical role in maintaining glomerular permselectivity.It has been long recognized that the podocyte actin cytoskeleton and the system of regulation are tightly associated with their normal function.A particular focus will be on the role of the Rho-family of small GTPases,represented by RhoA,Rac1,and Cdc42.Rho-GTPases are known for their versatile cellular functions,most importantly for the actin regulatory roles.The research will study the expression and the significance of RhoA and Cdc42 in renal tissues of IMN patients,and analyze the relationship between cytoskeleton and the pathogenesis of IMN,providing the basis for guiding prognosis and clinical treatment.Methods: 30 patients with IMN were from the nephrology department of the third hospital of Hebei Medical University between January 2015 and August 2015,which diagnosis was made by renal biopsy and immunohistochemical staining was showed positive for anti-PLA2 R antibody.We collected 14 hospitalized patients of MCD,14 hospitalized patients of IgA nephropathy(IgAN)and paraffin section of normal renal tissue of 4 patients with renal tumor as the control groups.The IMN,MCD and IgAN patients received renal biopsy for the first time.The IMN group was named as group I,and the MCD group was named as group II,and the IgAN group was named as group III.Immunohistochemistry method was used to detect the expression position of anti-PLA2 R antibody and RhoA,Cdc42 in renal tissues in normal renal tissue group,IMN group,MCD group and IgA group.The results have been semi-quantitative analyzed by image analysis system(Image-ProPlus,IPP).The experimental data are treated by statistical software SPSS 20.0.When P is less than 0.05 it is statistically significant.We use x ±s(mean±standard deviation)to show the measurement data.And count data are showed by rate or constituent ratio.Statistical comparisons of normal distribution data is analyzed by two independent sample t-test among groups.The correlation is tested with the linear correlation analysis.Results: RhoA and Cdc42 expressed infrequently and in parts of the glomerular capillary loops and cytoplasm of Bowman's capsule parictal of IMN group;The two factors expressed in renal tubular parietal epithelial cell in IMN group,which is less than IgA group and at the same time is more than MCD group.Conclusion: RhoA and Cdc42 play an important role in influencing the actin cytoskeleton to regulate cell morphological changes,movement and adhesion.They express increased in renal tubular parietal epithelial cell of IMN,which remindes that RhoA and Cdc42 affecte the stability of renal tubular epithelial cells actin cytoskeleton of IMN and participate in the tubulointerstitial lesions of IMN.And we speculate that the two factors may be related with prognosis of IMN.