腹膜透析滤出液外泌体细胞因子信号抑制物1、斑点蛋白140、钙周期蛋白结合蛋白表达对腹膜纤维化的诊断价值

    The value of exosomes suppressor of cytokine signaling 1,speckled protein 140 and calcyclin binding protein expressions in peritoneal dialysis effluent in the diagnosis of peritoneal fibrosis

    • 摘要: 目的 研究腹膜透析滤出液外泌体细胞因子信号抑制物1(suppressor of cytokine sig-naling 1,SOCS1)、斑点蛋白140(speckled protein 140,SP140)、钙周期蛋白结合蛋白(calcyclin bindingprotein,CacyBP)表达对腹膜纤维化(peritoneal fibrosis,PF)的诊断价值。方法 选择2021年11月1日至2023年9月30日期间河北北方学院附属第一医院行腹膜透析的90例终末期肾病患者作为研究对象,根据腹膜组织活检分为符合PF的PF组(n=38)和排除PF的对照组(n=52)。采用荧光定量聚合酶链式反应检测腹膜透析滤出液外泌体SOCS1、SP140、CacyBP的mRNA表达水平,采用腹膜平衡试验检测4 h超滤量、4 h时透析液肌酐与血肌酐比值(4 h dialysate/plasma creatinine,4 h D/PCr)、4 h和0 h时透析液葡萄糖含量比值(dialysate/dialysate at 0 h,D/D0)。分析SOCS1、SP140、CacyBP表达对PF的诊断价值。结果 PF组患者腹膜透析滤出液外泌体SOCS1(0.84±0.11)比(1.00±0.15)、SP140(0.82±0.12)比(1.00±0.13)、CacyBP(0.85±0.09)比(1.00±0.13)的mRNA表达水平低于对照组(P<0.05)。两组内、PF组内、对照组内腹膜透析滤出液外泌体SOCS1、SP140、CacyBP的mRNA表达水平与4 h超滤量、4 h D/PCr呈正相关,与D/D0呈负相关(P<0.05)。SOCS1、SP140、CacyBP表达水平对PF具有诊断价值,三者联合诊断PF的曲线下面积最大,为0.967(95%CI:0.936~0.997),灵敏度和特异度分别为90.38%和92.11%。结论 腹膜透析滤出液外泌体SOCS1、SP140、CacyBP表达降低与PF相关,三项指标联合对PF具有较好的诊断价值。

       

      Abstract: Objective To investigate the value of suppressor of cytokine signaling 1(SOCS1), speckled protein 140(SP140),calcyclin binding protein(CacyBP)expressions in peritoneal dialysis effluent in the diagnosis of peritoneal fibrosis(PF). Methods A total of 90 patients with end-stage renal disease who underwent peritoneal dialysis in the First Affiliated Hospital of Hebei North University from November 1,2021 to September 30,2023 were selected as study subjects. They were divided into PF group(n=38)and control group(non-PF,n=52)according to peritoneal tissue biopsy. The mRNA levels of exsome SOCS1,SP140 and CacyBP in peritoneal dialysis effluent were detected by quantitative reverse transcriptase polymerase chain reaction(qRT-PCR). The ultrafiltration volume at 4 h,4 h dialysate/plasma creatinine(4 h D/PCr),and the ratio of glucose content in dialysate at 4 h and 0 h(D/D0) were detected by peritoneal balance test. The diagnostic value of SOCS1,SP140 and CacyBP expressions in PF was analyzed. Results The mRNA levels of exosomes SOCS1[(0. 84 ±0. 11)vs(1. 00 ±0. 15)],SP140[(0. 82 ±0. 12)vs(1. 00 ±0. 13)]and CacyBP[(0. 85 ±0. 09)vs(1. 00 ±0. 13)]in peritoneal dialysis effluent of PF group were significantly lower than those of control group(P<0. 05). In both the PF group,and control group,the mRNA expression levels of exosomes SOCS1,SP140 and CacyBP in peritoneal dialysis effluent were positively correlated with 4 h ultrafiltration dose,and 4 h D/ PCr,and negatively correlated with D/D0(P<0. 05). The expression levels of SOCS1,SP140 and CacyBP had diagnostic value in PF. The area under the curve (AUC) of the combined diagnosis of SOCS1,SP140 and CACYBP was the largest(0. 967,95%CI:0. 936-0. 997),and the sensitivity and specificity were 90. 38% and 92. 11%,respectively. Conclusion The decreased expressions of exosomes SOCS1,SP140 and CacyBP in peritoneal dialysis effluent are related to PF,and the combination of these three indexes has a good diagnostic value for PF.

       

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