Diagnostic value of miR-485-3p in IgA nephropathy and its correlation with immunological parameters and T lymphocyte subsets
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摘要: 目的 探讨miR-485-3p对IgA肾病（IgA nephropathy，IgAN）的诊断价值及其与IgA/C3、CD4＋/CD8＋的相关性。方法 选取2018年1月至2020年12月三亚中心医院收治的IgAN患者106例（IgAN组）、非IgAN原发性肾小球肾炎患者90例（非IgAN组）和体检健康者50名（对照组）。检测各组miR-485-3p、免疫学指标（IgA、IgG、IgM、C3、C4、IgA/C3）以及T淋巴细胞亚群（CD4+、CD8+、CD4+/CD8+）水平。应用多因素Logistic回归分析影响IgAN发生的危险因素，绘制受试者工作特征（receiver operating fharacteristic curve，ROC）曲线分析miR-485-3p、IgA/C3及CD4+/CD8+诊断IgAN的价值。采用Pearson相关分析miR-485-3p表达水平与IgA、IgG、IgM、C3、C4、IgA/C3、CD4+、CD8+及CD4+/CD8+的相关性。结果 IgAN组miR-485-3p（0.48±0.06比1.20±0.25，1.96±0.73）、CD4+［（31.46±6.82）%比（42.15±8.40）%（47.50±9.35）%］及CD4+/CD8+（1.02±0.46比1.50±0.71，1.63±0.58）水平明显低于非IgAN组和对照组（P<0.001）。IgAN组IgA［（3.16±1.18）g/L比（2.05±0.73）g/L，（1.24±0.46）g/L］及IgA/C3（2.94±1.05比1.81±0.86，1.13±0.52）水平明显高于非IgAN组和对照组（P<0.001）。多因素Logistic回归分析，结果显示24h尿蛋白定量、IgA/C3水平高以及估算肾小球滤过率、CD4+/CD8+、miR-485-3p水平低是影响IgAN发生的危险因素（P<0.05）。ROC曲线结果显示，血清miR-485-3p表达水平诊断IgAN的曲线下面积（area undre the curve，AUC）为0.862（95%CI：0.803~0.922），其联合IgA/C3及CD4+/CD8+诊断IgAN的AUC高达0.937（95%CI：0.878~0.995），敏感度为96.3%，特异度为84.2%。相关分析显示，IgAN组血清miR-485-3p表达水平与IgA、IgA/C3呈负相关（r=-0.753、-0.827，P<0.05），与CD4+、CD4+/CD8+呈正相关（r=0.435、0.692，P<0.05）。结论 miR-485-3p在IgAN患者中呈低表达，与IgA/C3及CD4+/CD8+具有相关性，三项联合诊断IgAN的价值较高。
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关键词:
- 肾小球肾炎，IgA /
- MiR-485-3p /
- 免疫学指标 /
- T淋巴细胞亚群 /
- 诊断价值
Abstract: Objective To explore the diagnostic value of MiR-485-3p in IgA nephropathy (IgAN)and examine its correlation with IgA/C3 and CD4+/CD8+. Methods From January 2018 to December 2020, 106 IgAN patients(IgAN group), 90 non-IgA nephropathy patients with primary glomerulonephritis(non-IgAN group)and 50 normal subjects(control group)were selected. The levels of MiR-485-3p, immunological parameters(IgA, IgG, IgM, C3, C4 & IgA/C3)and T lymphocyte subsets(CD4+, CD8+ & CD4+/CD8+)were measured. Multivariate Logistic regression was employed for examining the risk factors for IgAN. And receiver operating characteristic(ROC)curve was plotted for analyzing the diagnostic values of miR-485-3p, IgA/C3 and CD4+/CD8+ for IgAN. The correlations between miR-485-3p expression level and IgA, IgG, IgM, C3, C4, IgA/C3, CD4+, CD8+ and CD4+/CD8+ were analyzed by Pearson's correlation. Results IgAN group miR-485-3p (0.48±0.06 vs 1.20±0.25, 1.96±0.73), CD4+[(31.46±6.82)% vs(42.15±8.40)%, (47.50±9.35)%]and CD4+/CD8+(1.02±0.46 vs 1.50±0.71, 1.63±0.58)were significantly lower than those in non-IgAN and control groups(P<0.001). Levels of IgA[(3.16±1.18) g/L vs(2.05±0.73) g/L, (1.24±0.46)g/L] and IgA/C3(2.94±1.05 vs 1.81±0.86, 1.13±0.52) were significantly higher in IgAN group than those in non-IgAN and control groups(P<0.001). Multivariate Logistic regression analysis revealed that high levels of urinary protein, IgA/C3 and low levels of eGFR, CD4+/CD8+ and miR-485-3p were risk factors for IgAN(P<0.05). ROC curve results indicated that AUC of serum expression level of miR-485-3p in the diagnosis of IgAN was 0.862(95%CI:0.803-0.922); AUC of miR-485-3p plus IgA/C3 and CD4+/CD8+ in the diagnosis of IgAN was 0.937(95%CI:0.878-0.995), sensitivity 96.3% and specificity 84.2%. Correlation analysis showed that serum expression level of miR-485-3p was correlated negatively with IgA and IgA/C3(r=-0.753, -0.827, P<0.05) and positively with CD4+, CD4+/CD8+(r=0.435, 0.692, P<0.05)in IgAN group. Conclusion The expression of miR-485-3p is low in IgAN patients. It is correlated with IgA/C3 and CD4+/CD8+ and combining three items has a high diagnostic value for IgAN. -
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[1] Rajasekaran A, Julian BA, Rizk DV.IgA nephropathy:an interesting autoimmune kidney disease[J].Am J Med Sci, 2021, 361(2):176-194.DOI: 10.1016/j.amjms.2020.10.003.
[2] Esteve Cols C, Graterol Torres FA, Quirant Sánchez B, et al.Immunological pattern in IgA nephropathy[J].Int J Mol Sci, 2020, 21(4):1389.DOI: 10.3390/ijms21041389.
[3] 裴改琴, 秦嫒雅, 王思清, 等.血清IgA/C3和病理C3沉积对IgA肾病患者临床预后的影响[J].中华医学杂志, 2020, 100(30):2372-2377.DOI: 10.3760/cma.j.cn112137-20200313-00745. Pei GQ, Qin AY, Wang SQ, et al.Effect of serum IgA/C3 and glomerular C3 staining on clinical prognosis in patients with IgA nephropathy[J].Natl Med J China, 2020, 100(30):2372-2377.DOI: 10.3760/cma.j.cn112137-20200313-00745.
[4] Stefan G, Stancu S, Boitan B, et al.Is there a role for IgA/C3 ratio in IgA nephropathy prognosis an outcome analysis on an European population[J].Iran J Kidney Dis, 2020, 14(6):470-477.
[5] Yao X, Zhai Y, An H, et al.MicroRNAs in IgA nephropathy[J].Ren Fail, 2021, 43(1):1298-1310.DOI: 10.1080/0886022X.2021.1977320.
[6] Wu J, Lu K, Zhu MY, et al.miR-485 suppresses inflammation and proliferation of mesangial cells in an in vitro model of diabetic nephropathy by targeting NOX5[J].Biochem Biophys Res Commun, 2020, 521(4):984-990.DOI: 10.1016/j.bbrc.2019.11.020.
[7] Miyabe Y, Karasawa K, Akiyama K, et al.Grading system utilising the total score of Oxford classification for predicting renal prognosis in IgA nephropathy[J].Sci Rep, 2021, 11(1):3584.DOI: 10.1038/s41598-021-82967-x.
[8] Wei SY, Guo S, Feng B, et al.Identification of miRNA-mRNA network and immune-related gene signatures in IgA nephropathy by integrated bioinformatics analysis[J].BMC Nephrol, 2021, 22(1):392.DOI: 10.1186/s12882-021-02606-5.
[9] Tang YY, He HD, Hu P, et al.T lymphocytes in IgA nephropathy[J].Exp Ther Med, 2020, 20(1):186-194.DOI: 10.3892/etm.2020.8673.
[10] Wang ZY, Liao Y, Wang LX, et al.Small RNA deep sequencing reveals novel miRNAs in peripheral blood mononuclear cells from patients with IgA nephropathy[J].Mol Med Rep, 2020, 22:3378-3386.DOI: 10.3892/mmr.2020.11405.
[11] Chang WH, Huang HY, Wang PH.The use of serum level of microRNA-485-5P in prediction of renal function in lupus nephritis patients[J].J Chin Med Assoc, 2021, 84(7):736.DOI: 10.1097/JCMA.0000000000000549.
[12] Tian Y, Han YX, Guo HF, et al.Upregulated microRNA-485 suppresses apoptosis of renal tubular epithelial cells in mice with lupus nephritis via regulating the TGF-β-MAPK signaling pathway by inhibiting RhoA expression[J].J Cell Biochem, 2018, 119:9154-9167.DOI: 10.1002/jcb.27178.
[13] Liu L, Yang YZ, Yu DR.Identification of key miRNAs and their targets in peripheral blood mononuclear cells of IgA nephropathy using bioinformatics analysis[J].Medicine, 2021, 100(26):e26495.DOI: 10.1097/MD.0000000000026495.
[14] Min QH, Chen XM, Zou YQ, et al.Differential expression of urinary exosomal microRNAs in IgA nephropathy[J].J Clin Lab Anal, 2018, 32(2):e22226.DOI: 10.1002/jcla.22226.
[15] 唐余燕, 贺海东, 孙蔚倩, 等.CD4+ T淋巴细胞在IgA肾病中致病作用机制研究[J].临床肾脏病杂志, 2020, 20(2):147-153.DOI: 10.3969/j.issn.1671-2390.2020.02.011. Tang YY, He HD, Sun WQ, et al.The pathogenesis of CD4+ T lymphocytes in IgA nephropathy[J].J Clin Nephrol, 2020, 20(2):147-153.DOI: 10.3969/j.issn.1671-2390.2020.02.011.
[16] Gong WY, Liu M, Luo D, et al.High serum IgA/C3 ratio better predicts a diagnosis of IgA nephropathy among primary glomerular nephropathy patients with proteinuria ≤ 1 g/d:an observational cross-sectional study[J].BMC Nephrol, 2019, 20(1):150.DOI: 10.1186/s12882-019-1331-0.
[17] Han X, Xiao Y, Tang Y, et al.Clinical and pathological features of immunoglobulin A nephropathy patients with nephrotic syndrome[J].Clin Exp Med, 2019, 19(4):479-486.DOI: 10.1007/s10238-019-00580-9.
[18] 李仪, 叶伟标, 冼丽英, 等.免疫球蛋白A肾病临床特征及外周血T细胞亚群、Th22变化研究[J].临床军医杂志, 2021, 49(2):188-189.DOI: 10.16680/j.1671-3826.2021.02.26. Li Y, Ye WB, Xian LY, et al.Clinical characteristics of immunoglobulin A nephropathy and changes of peripheral blood T cell subsets and Th22[J].Clin J Med Off, 2021, 49(2):188-189.DOI: 10.16680/j.1671-3826.2021.02.26.
[19] 刘林林, 姚丽.微小RNA与IgA肾病[J].中国实用内科杂志, 2020, 40(7):542-545.DOI: 10.19538/j.nk2020070104. Liu LL, Yao L.MicroRNA and IgA nephropathy[J].Chin J Pract Intern Med, 2020, 40(7):542-545.DOI: 10.19538/j.nk2020070104.
[20] Szeto CC, Wang G, Ng JKC, et al.Urinary miRNA profile for the diagnosis of IgA nephropathy[J].BMC Nephrol, 2019, 20(1):77.DOI: 10.1186/s12882-019-1267-4.
[21] 谢伟基,洪桂填,薛茜,等.血清IgA/C3对IgA肾病诊断及治疗预后的意义[J].临床肾脏病杂志,2019,19(5):311-316, 321.DOI: 10.3969/j.issn.1671-2390.2019.05.002. Xie WJ,Hong GT,Xue Q,et al.Significance of serum IgA/C3 ratio in the diagnosis and prognosis of IgA nephropathy[J].J ClinNephrol,2019,19(5):311-316,321.DOI: 10.3969/j.issn.1671-2390.2019.05.002.
[22] Yang LC, Zhang XY, Peng W, et al.microRNA-155-induced T lymphocyte subgroup drifting in IgA nephropathy[J].Int Urol Nephrol, 2017, 49(2):353-361.DOI: 10.1007/s11255-016-1444-3.
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