Efficiency and safety of Tripterygium Wilfordii Hook F for IgA nephropathy: an update systematic review and meta-analysis

Background:Immunoglobulin A Nephropathy(IgAN)currently stands as the most prevalent primary chronic glomerular disease worldwide.The latest guidelines recommend the application of renin-angiotensin system inhibitors(RASi)in conjunction with corticosteroids for the treatment of IgAN patients exhibiting persistent proteinuria of≥1 g/d.However,numerous randomized controlled trials(RCTs)have revealed a heightened risk of adverse events associated with corticosteroid treatment.Multi-glycoside of Tripterygium wilfordii Hook.f.(GTW),a traditional Chinese medicine(TCM),has been employed in the treatment of Chronic Kidney Disease(CKD)for an extensive period.Recent years have witnessed an increasing number of RCTs providing evidence supporting the effectiveness of GTW therapy in IgAN.Despite this,there remains a paucity of systematic reviews on the application of GTW therapy for IgAN.Consequently,this study undertakes a systematic review to assess the clinical efficacy and safety of GTW therapy,aiming to elucidate the role of GTW therapy in the treatment of IgAN.Methods:To collect relative information of randomized controlled trials(RCTs)of GTW in the treatment of IgAN,we searched for theses and dissertations publicized before April 10,2023,in PubMed,Embase,the Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data knowledge service platform(Wanfang Data),Chinese Scientific Journal Database(VIP),and Clinical Trial.The language limitation is English and Chinese.Independently,two reviewers performed literature screening,data extraction,and quality evaluation,and the meta-analysis was carried out with RevMan 5.4 and StataSE 15.0 software.Results:21 RCTs involving 1,405 Chinese patients were included.Compared to ACEI/ARB alone or in combination,GTW with RASi or alone reduced 24 h-Upro,ALB,Scr,GFR,BUN,CD4+,VEGF,ET-1,and improved clinical efficacy.However,no associations were found for TC,Ccr,and adverse events due to limited literature.Conclusion:This study highlights that Multi-glycoside of Tripterygium wilfordii Hook.f.(GTW)exhibits potential in safeguarding renal function and preserving the integrity of the basement membrane in patients with Immunoglobulin A Nephropathy(IgAN).Consequently,GTW emerges as a promising therapeutic option for individuals with IgAN.Nevertheless,it is crucial to acknowledge the limitations stemming from insufficient methodology and a small sample size,which currently obscure the relationships between certain clinical variables,such as total cholesterol(TC)and creatinine clearance(Ccr).Therefore,the substantiation of our findings necessitates more rigorous and expansive trials to enhance the robustness and generalizability of the results.

Efficacy of activating blood and resolving stasis therapy for IgA nephropathy:a systematic review and meta-analysis

Background:To systematically evaluate the efficacy and safety of activating blood and resolving stasis in patients with IgA nephropathy.Methods:From inception to May 2022,databases including PubMed,Embase,the Cochrane Library,Web of Science,WanFang database,Chinese Biomedical Database,VIP,and China National Knowledge Infrastructure were searched for randomized controlled trials about enhancing blood circulation and removing stasis for IgA nephropathy.For the articles that satisfied the requirements,quality assessment and meta-analysis were done.Results:Seventeen randomized controlled trials with a total of 1653 patients were included.Meta-analysis showed that activating blood and resolving stasis could increase therapeutic effectiveness(risk ratio(RR)=-0.47,95%confidence interval(CI)(-0.37,-0.2),P=0.0006)and decrease levels of serum creatinine(RR=-0.47,95%CI(-0.37,-0.2),P=0.0006),urea nitrogen(RR=0.85,95%CI(1.44,0.26),P=0.005),24-hour urinary protein quantification(RR=1.6,95%CI(2.44,0.95).P=0.00001),and urine red blood cell count(RR=1.7,95%CI(2.57,0.82),P=0.0001).There was no significant difference between the two groups in terms of security(RR=0.6,95%CI(0.36,1.01),P=0.05).Conclusion:Western medicine combined activating blood and resolving stasis is more efficient than Western medicine therapy alone in treating IgA nephropathy,but it still needs to be supported by additional large-scale,multi-center randomized controlled clinical trials due to the poor quality of the included trials.

IgA nephropathy associated with Crohn's disease

The relationship between IgA nephropathy(IgAN)and Crohn’s disease was reported.IgAN is the most common primary glomerulonephritis and one of the leading causes of chronic kidney disease and end-stage renal failure,and up to 50%of cases progressed to end-stage renal disease within 25 years after IgAN diagnosis.However,specific and effective therapeutic strategies are still lacking.In this review,we discuss the possibility of the mechanism involved in IgAN associated with Crohn’s disease based on the findings of basic and clinical studies.Although the etiology of IgAN associated with Crohn’s disease is not permanent and various factors are thought to be involved,the stabilization of the disease condition of Crohn’s disease is believed to help treat IgAN.

Analysis of the Effect of Hormone Therapy Combined with Hydroxychloroquine in the Treatment of IgA Nephropathy

Objective:To explore and analyze the effect of hormone therapy combined with hydroxychloroquine in the treatment of IgA nephropathy.Methods:30 patients with IgA nephropathy who were admitted to the Urology Department of Jiuquan hospital from August 2021 to May 2023 were selected as the research subjects,and they divided into an observation group and control group by drawing lots,with 15 cases in each group.The observation group underwent hydroxychloroquine treatment in addition of hormone therapy,and the control group underwent conventional treatment and hormone therapy.The rate of effectiveness of treatment,serum index,and renal function of both groups were compared.Results:The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in serum creatinine and serum albumin(P>0.05)between the groups before treatment;after treatment,the serum creatinine and serum albumin in the steroid group were significantly better than those in the reference group(P<0.05).Besides,there was no significant difference in urine protein quantification and glomerular filtration rate between the groups before treatment(P>0.05);after treatment,the hormone group’s urine protein quantification and glomerular filtration rate were significantly better than those in the reference group(P<0.05).The rate of effectiveness of the hormone group was significantly higher than that of the reference group(P<0.05).Conclusion:Hormone therapy combined with hydroxychloroquine in the treatment of IgA nephropathy is more effective than hormone therapy alone,thus this treatment plan is worthy of promotion and application.

Childhood Henoch-Schnlein Purpura Nephritis and IgA Nephropathy: One Disease Entity?——A Clinico-pathologically Comparative Study

Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.

IgA nephropathy treatment with traditional Chinese medicine:A case report

BACKGROUND IgA nephropathy(IgAN)is a common primary glomerular disease that leads to end-stage renal disease with poor therapy efficacy.Traditional Chinese medicine(TCM)is effective in the treatment of IgAN and has the potential to become an alternative treatment for IgAN.Professor Yan-Qin Zou is a nephropathy expert,a National Chinese Medicine Master,and an heir to the Menghe School of Medicine.CASE SUMMARY A 28-year-old man had positive urinary protein and elevated serum creatinine(Scr)results and was diagnosed with IgAN 2-3 years prior to the outpatient department visit at our hospital in 2017.Professor Zou used the following methods to treat the patient:Invigorating the spleen and tonifying the kidney,removing dampness and clearing turbidity,quickening the blood and transforming stasis,and freeing vessels and regulating collaterals.She adjusted the prescription in accordance with the patient’s symptoms.After 6 mo of treatment,the symptoms had resolved and serological indexes were also decreased[Scr from 288.5 to 188.6μmol/L,blood urea nitrogen(BUN)from 10.9 to 9.5 mmol/L,serum uric acid(UA)from 612 to 503μmol/L].During follow-up,BUN,Scr,and UA levels remained stable.CONCLUSION Professor Zou’s therapeutic strategy to treat IgAN using TCM was efficacious and a good reference for application.

Anti-glomerular basement membrane disease with IgA nephropathy: A case report

BACKGROUND Anti-glomerular basement membrane(GBM)disease is a rare autoimmune disease manifesting as acute progressive nephritis syndrome with or without varying degrees of pulmonary hemorrhage.Anti-GBM disease coexisting with Immunoglobulin A(IgA)nephropathy is rarer and has different clinical manifestations and prognoses than simple anti-GBM disease.We describe a case of coexistence of these two diseases.CASE SUMMARY A 49-year-old man with hematuria and proteinuria accompanied by a slight elevation of serum creatinine was admitted to our hospital.The pathological results of renal biopsy and the elevated serum anti-GBM antibody titer supported a diagnosis of anti-GBM disease combined with IgA nephropathy.After treatment with corticosteroids and cyclophosphamide,the patient's serum creatinine was relatively stable,and the hematuria and proteinuria moderately improved in the subsequent six months.CONCLUSION Anti-GBM disease coexisting with IgA nephropathy is rare.The clinical manifestations and prognosis are better than those of simple anti-GBM disease.In this case,the patient's condition was improved and his renal function remained relatively stable with corticosteroid and cyclophosphamide treatment.New detection methods to identify whether the crescents in this case were derived from anti-GBM disease or IgA nephropathy are worthy of further exploration.

Protective effects of Yishen Sanjie Huayu compound on the renal artery disease in rats with IgA nephropathy through ERK/NF-κB pathway

Objective:To observe the effect of Yishen Sanjie Huayu compound prescription on ERK/NF-κB signaling pathway in IgA nephropathy(IgAN)rats,and explore its effect on preventing and treating IgA nephropathy intrarenal arteriole disease.Methods:Fifty-five male SD rats were randomly divided into blank group,model group,ShenfukangⅡcapsule group and Losartan potassium tablet group.Bovine serum albumin(BSA)was used for intragastric administration and carbon tetrachloride(CCl4).IgAN rat model was established by subcutaneous injection and lipopolysaccharide(LPS)tail vein injection.ShenfukangⅡcapsule group and Losartan potassium tablet group were given each drug suspension 2ml/head/d one week after modeling Gavage was started.The blank group and the model group were given an equal volume of normal saline.The 24h urine protein(UTP)of the rats was measured at 4,8,and 12 weeks after the administration,and the blood creatinine(SCr)was measured after 12 weeks.,urea nitrogen(BUN),aldosterone(ADS),angiotensinⅡ(AngⅡ),immunohistochemical Envi-sion System two-step method to detect vascular endothelial growth factor(VEGF)and human matrix in the whole rat kidney and small artery area The expression of metalloproteinase-9(MMP-9),proliferating cell nuclear antigen(PCNA),extracellular regulatory protein kinase(ERK)1/2,nuclear transcription factor-κB(NF-κB),and the small arteries of rat kidney tissue The intima,media,vessel wall/vascular outer diameter value.Results:Compared with the model group,the expressions of VEGF,MMP-9,PCNA,ERK1/2 and NF-κB in kidney tissues of the ShenfukangⅡcapsule group and the Losartan potassium tablet group decreased(P<0.05),24hUTP and SCr,BUN level decreased(P<0.05),kidney tissue damage was alleviated;intima and vessel wall/vascular outer diameter values were significantly reduced(P<0.01),there was no significant difference in ADS between the groups.The AngⅡof the Tanpotassium tablets group was lower than that of the model group(P<0.05).Conclusion:Yishen Sanjie Huayu compound can inhibit the ERK/NF-κB signaling pathway in rats with IgA nephropathy,reduce the levels of VEGF,MMP-9,PCNA,ERK1/2,NF-κB,and inhibit intrarenal arteriole vascular endothelial cells Proliferate and reduce kidney damage.

Genetic polymorphisms of the renin-angiotensin-aldosterone system in Chinese patients with end-stage renal disease secondary to IgA nephropathy

Background Genetic variability in the renin-angiotensin-aldosterone system may modify renal responses to injury and disease progression. The angiotensin I-converting enzyme （ACE） gene insertion/deletion （I/D）, the angiotensinogen （AGT） gene, M235T, the aldosterone synthase （CYP11B2） gene, C-344T, and the angiotensin II type 1 receptor （AT1R） gene, Al166C, have been shown to be associated with IgA nephropathy （IgAN） and its progression. We determined the presence of these polymorphisms in 130 Chinese patients with IgAN, including 47 patients with end-stage renal disease （ESRD） and 120 healthy Chinese subjects, to assess their impact on the susceptibility to disease and the liability of progression to ESRD. Methods Genotyping was performed with DNA isolated from peripheral leucocytes using polymerase chain reaction amplification of the polymorphic sequence, restriction enzyme digestion, and separation and identification of DNA fragments. Clinical data from renal biopsies were collected. Results ACE, AGT, CYP and AT1R genotype distributions were similar in patients with IgAN and in controls. Comparing patients with ESRD （IgAN-ESRD） and those without ESRD （IgAN-non ESRD）, there was a significant increase only in the ACE DD genotype （P 〈0.05） among the four gene polymorphisms. There was significant dominance of the male （P 〈0.05）, more marked hypertension （P 〈0.01）, proteinuria （P 〈0.01） and increased serum creatinine during renal biopsy （P〈0.01） in the IgAN-ESRD group. Conclusion Among the ACE, AGT, ATIR and CYP gene polymorphisms, only the DD genotype may predispose the individual to increased risk of progression to ESRD in the Chinese population.

Retrospective study of mycophenolate mofetil treatment in IgA nephropathy with proliferative pathological phenotype

Background Mycophenolate mofetil （MMF） and cyclophosphamide （CTX） are widely used in treating various kidney diseases.However,whether they are effective and which one is better for treating IgA nephropathy patients with proliferative pathological phenotype in renal diseases,such as endocapillary proliferation,cellular crescents,and/or capillary loops fibrinoid necrosis is still unknown.We,therefore,initiated a study to compare the effects of MMF and CTX in treating IgA nephropathy with the above pathological lesions.Methods One hundred and nineteen patients with IgA nephropathy who had at least one of the three aforementioned lesions were enrolled.All patients were treated with prednisone; 48 patients received prednisone only （Pred group）,40 received MMF and prednisone （MMF ＋ Pred group）,and 31 were treated with CTX and prednisone （CTX ＋ Pred group）.The median time of follow-up was 30 months （maximum：96 months）.The primary endpoint was defined as renal survival.The incidence of remission of proteinuria was the secondary endpoint.Results Serum creatinine in all groups declined significantly at different follow-up times （P=0.002）,and the differences among the three groups were significant （P＜0.001）.At 24 months of follow-up,the decline rates were 12.35％,32.95％,and 24.14％ in the Pred,MMF ＋ Pred,and CTX ＋ Pred groups respectively.For urine protein excretion,the decline rates were 49.12％ （Pred）,73.67％ （MMF ＋ Pred）,and 63.53％ （CTX ＋ Pred） respectively at 24 months of follow-up.The differences among the three groups were not significant （P=0.714）.Renal survival （the primary endpoint） was significantly different （P=0.027）; however,the sencondary endpoint was similar for all the three groups （P=0.100）.Conclusions For IgA nephropathy patients with endocapillary proliferation,cellular crescents,and/or fibrinoid necrosis of capillary loops,prednisone combined with MMF was more effective in lowering the serum creatinine than with CTX.Combined MMF and orednisone treatment led to a better renal survival compared to that of prednisone with CTX.

Potential association of hyperhomocysteinemia with the progression of IgA nephropathy： a retrospective study

Background The high blood homocysteine （Hcy） levels found in patients with hyperhomocysteinemia （HHcy） have been implicated in an increased risk of cardiovascular disease morbidity and mortality in end-stage renal disease （ESRD）.This study investigated the association of HHcy with progression of IgA nephropathy.Methods We analyzed 108 participants newly diagnosed with IgA nephropathy between August 2005 and August 2007 in the Department of Nephrology,Chinese People＇s Liberation Army General Hospital.The association between clinicopathological factors and the Hcy levels were analyzed by Logistic regression and those with ESRD risk were analyzed by Cox regression.Results Patients were aged （35.71±10.73） years and included 45.71％ women and 12.04％ patients with HHcy.In multivariate Logistic regression analysis,HHcy was associated with arterial lesions （OR 2.60; 95％ CI 1.55-4.34; P＜0.001） even when age,body mass index,estimated glomerular filtration rate,mean arterial pressure,and initial proteinuria were taken into account.Mean follow-up was （67.37±16.21） months.HHcy was also associated with worse ESRD-free survival （HR 4.71; 95％ CI 1.45 to 15.31; P=0.010）.Conclusion HHcy is associated with the risk of intrarenal arterial lesions and may be useful for estimating the prognosis of IgA nephropathy.

Baseline proteinuria, urinary osmotic pressure, and renal function as positive predictors of corticosteroids plus cyclophosphamide treatment efficacy in IgA nephropathy

Background Very limited data are available on factors predictive of corticosteroids plus cyclophosphamide treatment efficacy on IgA nephropathy （IgAN）.The aim of the study was to research the clinical factors predictive of treatment efficacy in IgAN.Methods One hundred and fifty-nine patients with IgAN （proteinuria ≥2 g/d and estimated glomerular filtration rate 30-89 ml·min-1·1.73 m-2） were treated with corticosteroids/cyclophosphamide followed by a 12-month follow-up.According to their response,these patients were divided into remission group （proteinuria ＜0.5 g/d） and non-remission group （proteinuria ≥0.5 g/d）,and their clinical data collected.Results In the present study,72.96％ of the individuals underwent a complete remission,and their response was related to baseline proteinuria,urinary osmotic pressure,and renal function （P ＜0.05）.Patients with baseline proteinuria more than 3 g/d,urinary osmotic pressure greater than 600 mOsm/L,and eGFR 60-89 ml·min-1·1.73 m-2 responded well to the combination of corticosteroids and cyclophosphamide （86.90％ vs.57.33％,P=0.000; 81.48％ vs.64.10％,P=0.014; 83.17％ vs.55.17％,P=0.000）.Conclusion The response to the combination of corticosteroids and cyclophosphamide might be well associated with baseline proteinuria,urinary osmotic pressure,and renal function in patients with IgAN.

Lipidomics reveals association of circulating lipids with body mass index and outcomes in IgA nephropathy patients

IgA nephropathy(IgAN)is a leading cause of chronic kidney disease(CKD),which are commonly accompanied by dyslipidemia.Obesity is also associated with dyslipidemia and risk of CKD,but the relation of the dyslipidemia patterns with obesity and disease progression in IgAN patients remains unknown.Traditional Chinese medicine(TCM)and the combined treatment with corticosteroids and TCM have been shown to be of benefit for IgAN patients,but predictive markers for guiding these treatments are lacking.Here,we quantified 545 lipid species in the plasma from 196 participants,including 140 IgAN patients and 56 healthy volunteers,and revealed an altered plasma lipidome in IgAN patients as compared to healthy participants.Association analysis showed that a subgroup of glycerides,particularly triacylglycerols(TGs)containing docosahexaenoic acid,were positively associated with high body mass index(BMI)in under-or normal-weight IgAN patients,while several free fatty acids and sphingomyelins were positively associated with high BMI in overweight or obese IgAN patients.Further,our study suggested that elevated levels of eight lipids,mainly TG species containing linolenic acid,were independent risk factors for IgAN progression and also reported the prospective association of circulating lipids with treatment outcomes in IgAN.Taken together,our findings may not only help to achieve precision medicine but also provide a knowledge base for dietary intervention in the treatment of IgAN.

Potential of Renal Pathology on Refining Syndrome Typing of Chinese Medicine in IgA Nephropathy

Objective： To investigate the potential of renal pathological index as a differential diagnosis factor for Chinese medicine （CM） syndromes typing in IgA nephropathy （IgAN）. Methods： A total of 1,016 patients with IgAN was recruited from November 2001 to November 2004. All the signs and symptoms including picture of the tongue and pulse tracings were collected. All patients were typed according to the CM syndrome typing scheme for chronic primary glomerulopathy. The severity of glomerulus and tubulointerstitial lesions （mild, moderate- severe） were evaluated using lee＇s grading system and the Katafuchi score system. Results： The syndrome types transform in turn by deficiency of both the Spleen （Pi） and Lung （Fei） qi, deficiency of both qi and yin, deficiency of Liver （Gan） and Kidney （Shen） yin and deficiency of Spleen-Kidney （Shen） yang, with the aggravation of pathogenetic condition and that the manifestation of deficiency of qi clinically showed proliferative lesion of glomerular mesangium, while the glomerular sclerosis pathologically showed the manifestation of yin deficiency. Conclusion： Renal pathological findings may be a candidate of objective factors to refine CM syndrome typing process.

Clinical and Pathological Implications of Increases in Tonsillar CD19+CD5+B Cells,CD208+Dendritic Cells,and IgA1-positive Cells of Immunoglobulin A Nephropathy

Objective:Several studies indicated that tonsillectomy can improve the prognosis of patients with immunoglobulin A nephropathy(IgAN).However,the relationship between tonsillar immunity and IgAN is still unclear.Methods:A total of 14 IgAN patients were recruited in the current study from May 2015 to April 2016 in Tongji Hospital.B cells,dendritic cells(DCs),and IgAl positive cells in human tonsils were detected using immunofluorescence and immunohistochemistry.Correlations between these cells and clinicopathologic features were evaluated.

Tumor suppressor cylindromatosis： expressed in IgA nephropathy and negatively associated with renal tubulo-interstitial lesion

Background IgA nephropathy is the major cause of end-stage renal failure in patients with primary glomerular diseases. Tumor suppressor cylindromatosis （CYLD）, the recently identified member of the deubiquitinating enzymes, has been actively involved in regulation of inflammation. This study was undertaken to investigate the CYLD expression profile in IgA nephropathy and identify factors associated with CYLD expression. Methods Forty-one cases of IgA nephropathy were selected. CYLD expression in the kidney biopsy tissue was measured by immunohistochemical staining. Relevant clinical and pathological data were analyzed, and Logistic regression analysis was carried out to identify factors associated with CYLD expression. Results CYLD was specifically expressed in renal tubular epithelial cells in 70% of the studied patients with IgA nephropathy. All patients with positive CYLD staining had proteinuria, while only 72.7% of patients with negative CYLD had proteinuria （P=0.003）. Among studied proteinuric patients, those with positive CYLD had significantly less tubulo-interstitial lesions and higher estimated glomerular filtration rate （eGFR） levels when compared with those patients showed negative CYLD results. Logistic regression analysis indicated that the urinary protein excretion and eGFR were identified as predictors for the CYLD expression. Conclusion CYLD is expressed in renal tubular epithelial cells and appears to be associated negatively with tubulointerstitial lesions, however, its exact functional role remains to be clarified in further experiments.

Association of secretory IgA with clinical pathological characteristics and complement activation in IgA nephropathy

Objective To further investigate the association among clinical pathology,complement activation and renal secretory IgA(SIgA)deposition in patients with IgA nephropathy(IgAN).Methods The activation of serum complements was detected by immunoturbidimetry and ELISA.Renal deposition of SIgA and activation of complements were detected by immunofluorescence.