狼疮性肾炎患者外周血单个核细胞中miR-21、miR-423的表达水平及临床意义

Expression levels and clinical significance of miR-21 and miR-423 in peripheral blood mononuclear cells of patients with lupus nephritis

目的探讨狼疮性肾炎(LN)患者外周血单个核细胞(PBMC)中微小RNA-21(miR-21)及微小RNA-423(miR-423)的表达水平及临床意义。方法选取2017年1月至2019年9月该院收治的LN患者118例为研究对象(LN组)。根据LN分型标准分为LNⅡ~Ⅲ型组39例,Ⅳ型组47例,Ⅴ~Ⅵ型组32例;根据SLE疾病活动度指数(SLEDAI)评分分为LN稳定组40例,LN活动组78例;根据慢性肾脏病分期标准分为早期LN组79例,晚期LN组39例;另选取健康体检者50例为对照组。采用实时荧光定量PCR检测各组PBMC中miR-21及miR-423的表达水平。采用Pearson相关分析LN患者PBMC中miR-21及miR-423表达水平与各实验室指标的相关性。结果LN组、LN活动组和LN稳定组PBMC中miR-21及miR-423表达水平均明显高于对照组(P<0.05);LN活动组PBMC中miR-21及miR-423表达水平均明显高于LN稳定组(P<0.05)。Ⅱ~Ⅲ型组、Ⅳ型组、Ⅴ~Ⅵ型组PBMC中miR-21及miR-423表达水平均明显高于对照组(P<0.05);Ⅴ~Ⅵ型组和Ⅳ型组PBMC中miR-21及miR-423表达水平均明显高于Ⅱ~Ⅲ型组(P<0.05)。晚期LN组和早期LN组PBMC中miR-21及miR-423表达水平均明显高于对照组(P<0.05);晚期LN组PBMC中miR-21及miR-423表达水平均明显高于早期LN组(P<0.05)。相关性分析结果显示,LN患者PBMC中miR-21及miR-423表达水平与抗双链DNA抗体、血肌酐、血尿素氮水平及SLEDAI评分均呈正相关(P<0.05),与补体C3、补体C4及清蛋白水平均呈负相关(P<0.05)。结论LN患者PBMC中miR-21及miR-423表达水平明显升高,且miR-21及miR-423表达水平升高与疾病活动度及病情严重程度密切相关。

Objective To investigate the expression levels and clinical significance of microRNA-21(miR-21)and microRNA-423(miR-423)in peripheral blood mononuclear cells(PBMC)of patients with lupus nephritis(LN).Methods A total of 118 patients with LN(LN group)admitted to the hospital from January 2017 to September 2019 were selected as the research objects.According to the classification criteria of LN,the patients were divided into typeⅡ-Ⅲgroup(39 cases),typeⅣgroup(47 cases)and typeⅤ-Ⅵgroup(32 cases).According to the score of SLE disease activity index(SLEDAI),the patients were divided into LN stable group(40 cases)and LN active group(78 cases).According to the stage standard of chronic kidney disease,the patients were divided into early LN group(79 cases)and late LN group(39 cases).Another 50 healthy people underwent physical examination were selected as the control group.The expression levels of miR-21 and miR-423 in PBMC of each group were detected by real-time fluorescence quantitative PCR.Pearson correlation analysis was used to analyze the correlation between the expression levels of miR-21 and miR-423 in PBMC of LN patients with each laboratory index.Results The expression levels of miR-21 and miR-423 in PBMC of LN group,LN active group and LN stable group were significantly higher than those of control group(P<0.05).The expression levels of miR-21 and miR-423 in PBMC of LN active group were significantly higher than those of LN stable group(P<0.05).The expression levels of miR-21 and miR-423 in PBMC of typeⅡ-Ⅲgroup,typeⅣgroup andⅤ-Ⅵgroup were significantly higher than those of control group(P<0.05).The expression levels of miR-21 and miR-423 in PBMC of typeⅤ-Ⅵgroup and typeⅣgroup were significantly higher than those of typeⅡ-Ⅲgroup(P<0.05).The expression levels of miR-21 and miR-423 in PBMC of late LN group and early LN group were significantly higher than those of control group(P<0.05).The expression levels of miR-21 and miR-423 in PBMC of late LN group were significantly higher than those of early LN group(P<0.05).Correlation analysis showed that the expression levels of miR-21 and miR-423 in PBMC of LN patients positively correlated with anti-double-stranded DNA antibody,serum creatinine,serum urea nitrogen levels and SLEDAI score(P<0.05),and negatively correlated with complment C3,complment C4 and albumin levels(P<0.05).Conclusion The expression levels of miR-21 and miR-423 in the PBMC of LN patients significantly increase,and the increase expression levels of miR-21 and miR-423 closely relate to disease activity and severity of the disease.