血清甘露糖结合凝集素、甘露糖结合凝集素相关丝氨酸蛋白酶-2在IgA肾病中的作用

Role of serum mannose-binding lectin and mannose-binding lectin-associated serine protease 2 in IgA nephropathy

目的:检测原发性IgA肾病患者及健康人群血清标本中MBL、MASP-2的浓度,研究其在IgA肾病中的作用。方法:选取2020年12月~2021年12月在包头医学院第一附属医院肾内科首次经肾穿刺活检确诊为IgA肾病的患者33例作为IgAN组,同期在同一医院体检的健康志愿者33例作为健康对照组。用ELISA法测定两组血清MBL、MASP-2浓度,分析血清MBL、MASP-2浓度与临床指标、病理参数的关系。结果:IgAN组患者血清MBL浓度高于健康对照组,MASP-2浓度两组间无差异。IgAN患者血清MBL与24hUP、LDL-C、UA、T≥1呈正相关,与ALB呈负相关,血清MASP-2与ESR呈正相关。结论:补体MBL途径参与IgAN的疾病过程,IgAN患者血清MBL浓度增高与尿蛋白量增多、血白蛋白降低、嘌呤及脂代谢异常、肾小管/间质损伤有关,高浓度的血清MBL可能是IgAN发生发展的重要因素。IgAN患者血清MASP-2浓度的增高可能伴随疾病慢性炎症状态。

Objective:To detect the concentration of MBL and MASP-2 in serum samples of patients with primary IgA nephropathy and healthy people,and to study its role in IgA nephropathy.Methods:Thirty-three patients with IgA nephropathy diagnosed by renal biopsy for the first time in the Department of Nephrology of the First Affiliated Hospital of Baotou Medical College from December 2020 to December 2021 were selected as the IgAN group,and 33 healthy volunteers who underwent physical examination in the same hospital during the same period were selected as the healthy control group.Serum MBL and MASP-2 concentrations were measured by ELISA,and the relationship between serum MBL and MASP-2 concentrations and clinical indicators and pathological parameters was analyzed.Results:The serum MBL concentration in IgAN group was higher than that in healthy control group,and there was no difference in MASP-2 concentration between the two groups.The serum MBL of IgAN patients was positively correlated with 24 hUP,LDL-C,UA and T≥1,and negatively correlated with ALB.The serum MASP-2 was positively correlated with ESR.Conclusion:Complementary MBL pathway is involved in the disease process of IgAN.The increase of serum MBL concentration in IgAN patients is related to the increase of urinary protein,the decrease of serum albumin,the abnormality of purine and lipid metabolism,and the injury of renal tubule/interstitial.High concentration of serum MBL may be an important factor in the occurrence and development of IgAN.Increased serum MASP-2 levels in IgAN patients may be associated with chronic inflammation.