IgA肾病患者血清外泌体中NLRP3的表达及与疾病严重程度的相关性

Expression of NLRP3 in serum exosomes of IgA nephropathy patients and its correlation with severity of the disease

目的 :观察免疫球蛋白A(immunoglobulin A, IgA)肾病患者血清外泌体中炎症小体NOD样受体热蛋白结构域相关蛋白3(NOD-like receptor thermal protein domain associated protein 3, NLRP3)的表达变化,分析其与疾病严重程度的相关性。方法:选取2018年1月—2019年12月在南通大学附属医院肾活检为原发性IgA肾病患者60例,根据肾脏病理Katafuchi积分分为4组:0~3分17例、4~6分19例、7~9分15例、10~12分9例;另选择因肾良性肿瘤行手术切除患者15例为对照组。收集IgA肾病患者血清外泌体,免疫组化试剂盒检测外泌体中NLRP3的表达,Pearson相关分析法分析血清外泌体NLRP3的表达与Katafuchi积分、24 h尿蛋白定量、内生肌酐清除率的相关性,并分析血清外泌体NLRP3的表达与肾组织内NLRP3表达的相关性。结果 :IgA肾病患者血清外泌体中NLRP3的表达明显高于对照组(P<0.05),其表达水平与蛋白尿、Katafuchi积分呈正相关(P<0.05),与内生肌酐清除率呈负相关(P<0.05)。IgA肾病患者肾脏组织内NLRP3的表达较对照组明显升高(P<0.05),且与血清外泌体中NLRP3的表达呈正相关(P<0.05)。结论:IgA肾病患者血清外泌体中NLRP3的表达与疾病的严重程度呈正相关,可能参与疾病的发生及发展。

Objective: To observe the expression of NOD-like receptor protein 3(NLRP3) in serum exosomes of immunoglobulin A(IgA) nephropathy patients and its correlation with severity of the disease. Methods: A total of 60 patients with primary IgA nephropathy who underwent kidney biopsy from January 2018 to December 2019 were divided into four groups according to the Katafuchi score of Ig A nephropathy:0-3 points(17 cases), 4-6 points(19 cases), 7-9 points(15 cases), and 10-12 points(9 cases). 15 patients who underwent surgical resection because of benign kidney tumors were control group. Blood and serum exosomes were collected from IgA nephropathy patients. NLRP3 expression in exosomes was detected by immunohistochemistry kit. Pearson correlation analysis was used to analyze the relationships of the expression of NLRP3 in serum exosomes with Katafuchi scores, 24 h urine protein quantification, endogenous creatinine clearance and the relationship of expression of NLRP3 in serum exosomes and in renal tissue. Results: The expression of NLRP3 in serum exosomes was significantly higher in IgA nephropathy groups than that in control group(P<0.05), and its expression was positively related with protein urinary and Katafuchi scores(P<0.05) and negatively with endophytic creatinine clearance(P<0.05). The expression of NLRP3 in renal tissue was higher compared with the control group(P<0.05) and positively correlated with the expression of NLRP3 in serum exosomes(P<0.05). Conclusion: The expression of NLRP3 in the serum exosomes is positively associated with severity of IgA nephropathy, and may participate in the occurrence and development of the disease.