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Nieto-Gañán I, Iturrieta-Zuazo I, Rita C, Carrasco-Sayalero Á. Revisiting immunological and clinical aspects of membranous nephropathy. Clin Immunol 2022; 237:108976. [PMID: 35276323 DOI: 10.1016/j.clim.2022.108976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/16/2022] [Accepted: 03/05/2022] [Indexed: 11/29/2022]
Abstract
Idiopathic or primary membranous nephropathy (IMN) is one of the most frequent causes of nephrotic syndrome in adults and the elderly. It is characterized by a thickening of the wall of the glomerular capillaries due to the presence of immune complex deposits. 85% of membranous nephropathy cases are classified as primary or idiopathic (IMN). The rest are of secondary origin (SMN), caused by autoimmune conditions or malignant tumors as lung cancer, colon and melanomas. It is an organ-specific autoimmune disease in which the complement system plays an important role with the formation of the membrane attack complex (MAC; C5b-9), which produces an alteration of the podocyte structure. The antigen responsible for 70-80% of IMN is a podocyte protein called M-type phospholipase A2 receptor (PLA2R). More recently, another podocyte antigen has been identified, the "Thrombospondin type-1 domain-containing 7A" (THSD7A), which is responsible for 10% of the cases of negative IMN for anti- PLA2R.
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Affiliation(s)
- Israel Nieto-Gañán
- Immunology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - Ignacio Iturrieta-Zuazo
- Immunology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Spain
| | - Claudia Rita
- Immunology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Khaliq OP, Konoshita T, Moodley J, Naicker T. The association of NPHS1 and ACNT4 gene polymorphisms with pre-eclampsia. Eur J Obstet Gynecol Reprod Biol 2021; 266:9-14. [PMID: 34555552 DOI: 10.1016/j.ejogrb.2021.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/18/2021] [Accepted: 09/08/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The main objective of this study is to investigate the association of the NPHS1 gene polymorphisms (rs437168) and ACTN4 (rs3745895) in the pathogenesis of PE in women of African Ancestry. MATERIALS AND METHODS 637 blood samples, normotensive pregnant (n = 280) and pre-eclampsia (n = 357) were included. The PE group was sub-divided into early onset pre-eclampsia (n = 187) and late onset pre-eclampsia (n = 170). rs74315346, rs869025495, rs121908415, rs3745895, and rs437168 were genotyped from isolated DNA using real time PCR. RESULTS The C allele of rs437168 (NPHS1) was significantly higher in PE compared to controls. [C vs T; p = 0.0323*] and [CC vs CT/TT; p = 0.0464*]. A comparison between the subtypes of PE and controls showed that the C allele was significantly higher in EOPE compared to controls [p = 0.0027**], [CC vs CT/TT; p = 0.0111*], [CC/CT vs TT p = 0.0198*] and LOPE. [p = 0.0259*]. The other SNPs genotyped showed no signification associations with PE. CONCLUSION This study found that the C allele of rs437168 is significantly associated with the pathogenesis of early onset PE and may be accountable for renal injury, which is a risk factor for the development of EOPE in women of African Ancestry.
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Affiliation(s)
- Olive P Khaliq
- Optics and Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences, University of KwaZulu-Natal, South Africa.
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medicine Sciences, Fukui, Japan
| | - Jagidesa Moodley
- Department of Obstetrics and Gynecology and Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa
| | - Thajasvarie Naicker
- Optics and Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences, University of KwaZulu-Natal, South Africa
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A descriptive study of NPHS1 and NPHS2 mutations in children with congenital nephrotic syndrome. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Xu Z, Chen L, Xiang H, Zhang C, Xiong J. Advances in Pathogenesis of Idiopathic Membranous Nephropathy. KIDNEY DISEASES (BASEL, SWITZERLAND) 2020; 6:330-345. [PMID: 33490113 PMCID: PMC7745661 DOI: 10.1159/000507704] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 04/02/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Membranous nephropathy (MN), a major cause of nephrotic syndrome, has attracted people's attention in recent years for its growing prevalence. It is the second or third leading cause of ESRD in patients with primary glomerulonephritis and is the leading glomerulopathy that recurs after kidney transplantation. SUMMARY MN can be classified as idiopathic membranous nephropathy (IMN) and secondary MN. The discovery of the M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A) provides the new diagnostic methods and treatment strategies for IMN on the molecular level. The study on single nucleotide polymorphism of IMN genes, such as the single M-type phospholipase A2 receptor 1 (PLA2R1) gene and human leukocyte antigen (HLA) gene, explains the pathogenesis of the disease from the perspective of genetics and conforms to the trend of the era of precision medicine. KEY MESSAGES This review focuses on advances in the pathogenesis of IMN, including molecular and genetic pathogenesis, as well as discussing the diagnostic and treatment guiding value brought by these new discoveries.
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Affiliation(s)
- Zhifeng Xu
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Chen
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiling Xiang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Xiong
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Liu D, Zhang J, Shi Y, Liu Z. Gene polymorphism and risk of idiopathic membranous nephropathy. Life Sci 2019; 229:124-131. [DOI: 10.1016/j.lfs.2019.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/30/2019] [Accepted: 05/06/2019] [Indexed: 01/09/2023]
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Zhang C, Leng L, Zhang X, Zhao Y, Li Z. Comprehensive identification of immune-associated biomarkers based on network and mRNA expression patterns in membranous glomerulonephritis. J Transl Med 2018; 16:210. [PMID: 30041664 PMCID: PMC6056925 DOI: 10.1186/s12967-018-1586-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Membranous glomerulonephritis (MGN) is the most common cause of nephrotic syndrome in adult patients. Despite extensive evidences suggested that many immune-related genes could serve as effective biomarkers in MGN, the potential has not been sufficiently understood because of most previous studies have concentrated on individual gene and not the entire interaction network. METHODS Here, we integrated multiple levels of data containing immune-related genes, MGN-related genes, protein-protein interaction (PPI) networks and gene expression profiling data to construct an immune or MGN-directed neighbor network (IOMDN network) and an MGN-related genes-directed network (MGND network). RESULTS Our analysis suggested that immune-related genes in the PPI network have special topological characteristics and expression pattern related to MGN. We also identified five network modules which showed tighter network structure and stronger correlation of expression. In addition, functional and drug target analyses of genes in modules indicated that the potential mechanism for MGN. CONCLUSIONS Collectively, these results indicated that the strong associations between immune and MGN and showed the potential of immune-related genes as novel diagnostic and therapeutic targets for MGN.
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Affiliation(s)
- Chengwei Zhang
- Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150006, Heilongjiang, People's Republic of China.
| | - Lei Leng
- The Second Hospital of Harbin, Heilongjiang, 150006, People's Republic of China
| | - Xiaoming Zhang
- Xiangan Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, 710000, Shanxi, People's Republic of China
| | - Yao Zhao
- Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150006, Heilongjiang, People's Republic of China
| | - Zhaozheng Li
- Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150006, Heilongjiang, People's Republic of China
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Lai WL, Yeh TH, Chen PM, Chan CK, Chiang WC, Chen YM, Wu KD, Tsai TJ. Membranous nephropathy: a review on the pathogenesis, diagnosis, and treatment. J Formos Med Assoc 2015; 114:102-11. [PMID: 25558821 DOI: 10.1016/j.jfma.2014.11.002] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 11/07/2014] [Accepted: 11/12/2014] [Indexed: 11/25/2022] Open
Abstract
In adults, membranous nephropathy (MN) is a major cause of nephrotic syndrome. However, the etiology of approximately 75% of MN cases is idiopathic. Secondary causes of MN are autoimmune diseases, infection, drugs, and malignancy. The pathogenesis of MN involves formation of immune complex in subepithelial sites, but the definite mechanism is still unknown. There are three hypotheses about the formation of immune complex, including preformed immune complex, in situ immune-complex formation, and autoantibody against podocyte membrane antigen. The formation of immune complex initiates complement activation, which subsequently leads to glomerular damage. Recently, the antiphospholipase A2 receptor antibody was found to be associated with idiopathic MN. This finding may be useful in the diagnosis and prognosis of MN. The current treatment includes best supportive care, which consists of the use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, lipid-lowering agents, and optimal control of blood pressure. Immunosuppressive agents should be used for patients who suffer from refractory proteinuria or complications associated with nephrotic syndrome. Existing evidence supports the use of a combination of steroid and alkylating agents. This article reviews the epidemiology, pathogenesis, diagnosis, and the treatment of MN.
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Affiliation(s)
- Wei Ling Lai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ting Hao Yeh
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ping Min Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chieh Kai Chan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen Chih Chiang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yung Ming Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kwan Dun Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tun Jun Tsai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Idiopathic membranous nephropathy and IgG4: an interesting relationship. Clin Nephrol 2014; 82:7-15. [PMID: 23380389 PMCID: PMC4928035 DOI: 10.5414/cn107768] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2014] [Indexed: 12/24/2022] Open
Abstract
Idiopathic membranous nephropathy (iMN) is a single-organ autoimmune disease characterized by subepithelial deposition of immune complexes containing IgG4 resulting in proteinuria, nephrotic syndrome, and, in some, end-stage renal disease. The pathogenesis involves a chronic IgG4 response against specific podocyte antigens which have now been at least partially defined in the neonatal, early childhood, and adult varieties. More has recently been learned about the genetic predisposition as well. This review discusses the pathophysiology of iMN in light of these discoveries and what is known about the genesis and potential clinical ramifications of an antigen-specific IgG4 response.
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Chen SY, Chen CH, Huang YC, Chan CJ, Chen DC, Tsai FJ. Genetic susceptibility to idiopathic membranous nephropathy in high-prevalence Area, Taiwan. Biomedicine (Taipei) 2014; 4:9. [PMID: 25520922 PMCID: PMC4265015 DOI: 10.7603/s40681-014-0009-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 05/04/2014] [Indexed: 12/24/2022] Open
Abstract
Idiopathic membranous nephropathy (MN) is one common cause of idiopathic nephrotic syndrome in adults; 25% of MN patients proceed to end-stage renal disease. In adults, membranous nephropathy is a lead cause of nephrotic syndrome, with about 75% of the cases idiopathic. Secondary causes include autoimmune disease, infection, drugs and malignancy. Three hypotheses about pathogenesis have surfaced: preformed immune complex, in situ immune complex formation, and auto-antibody against podocyte membrane antigen. Pathogenesis does involve immune complex formation with later deposition in sub-epithelial sites, but definite mechanism is still unknown. Several genes were recently proven associated with primary membranous nephropathy in Taiwan: IL-6, NPHS1, TLR-4, TLR-9, STAT4, and MYH9 . These may provide a useful tool for diagnosis and prognosis. This article reviews epidemiology and lends new information on KIRREL2 (rs443186 and rs447707) polymorphisms as underlying causes of MN; polymorphisms revealed by this study warrant further investigation.
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Affiliation(s)
- Shih-Yin Chen
- Genetics Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan ; Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan ; Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
| | - Cheng-Hsu Chen
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Chuen Huang
- Genetics Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan ; Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan
| | - Chia-Jung Chan
- Genetics Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Da-Chung Chen
- Taiwan LandSeed Hospital, Pingjen City, Taoyuan, Taiwan ; Department of Chemical and Materials Engineering, National Central University, Taoyuan, Taiwan
| | - Fuu-Jen Tsai
- Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan ; Department of Medical Genetics, China Medical University Hospital, No. 2, Yuh Der Road, 404, Taichung, Taiwan ; Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
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Ramireddy L, Chen WTL, Peng CT, Hu RM, Ke TW, Chiang HC, Chang SC, Tsai FJ, Lo WY. Association Between Genetic Polymorphism of the MIF Gene and Colorectal Cancer in Taiwan. J Clin Lab Anal 2014; 29:268-74. [PMID: 24840392 DOI: 10.1002/jcla.21763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 03/14/2014] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the highest leading cause of cancer-related mortality in Taiwan. Macrophage migration inhibitory factor (MIF) has recently been defined as a novel protumorigenic factor that promotes cell proliferation, migration, and invasion. The aim of the present study is to identify the association between MIF gene polymorphism and CRC. METHODS A case-control study was designed to test the hypothesis. A total of 192 biopsy-diagnosed CRC patients (CRC) and 256 healthy subjects (control) were recruited. Genotyping of four single nucleotide polymorphism (SNPs; rs755662, rs11548059, rs1049829, rs1803976) at chromosome positions 755662 (5' UTR), 11548059 (exon2), 1049829 (exon2), 1803976 (exon3) was performed using a Taqman SNP genotyping assay. RESULTS There is a significant difference in genotype frequency distribution of rs755662 polymorphism between CRC patients and controls (P = 0.011). No significant difference was found in the frequency distribution of rs11548059, rs1049829, rs1803976 polymorphism in CRC patients and controls (P = 0.660, P = 0.700, and P = 0.959, respectively). Moreover, the MIF-173 SNP was also significantly associated with young patients (age < 50 years, P = 0.026) late stage (Stage IV, P = 0.038) and poor differentiation group (P = 0.040). Compared to the control group, the MIF-173 SNP also significantly associated with patients with stages III and IV (P = 0.034 and 0.003, respectively). CONCLUSION The presence of MIF-173 (G/C) gene polymorphism (rs755662) was associated with susceptibility, patient age, and stages of CRC in Taiwanese.
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Affiliation(s)
- Latha Ramireddy
- Department of Biomedical Informatics, Asia University, Taichung, Taiwan
| | - William Tzu-Liang Chen
- Division of Colorectal Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Ching-Tien Peng
- Department of Biomedical Informatics, Asia University, Taichung, Taiwan.,Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan
| | - Rouh-Mei Hu
- Department of Biomedical Informatics, Asia University, Taichung, Taiwan
| | - Tao-Wei Ke
- Division of Colorectal Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Hua-Che Chiang
- Division of Colorectal Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Sheng-Chi Chang
- Division of Colorectal Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Fuu-Jen Tsai
- Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan
| | - Wan-Yu Lo
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.,Department of Life Science, National Chung Hsing University, Taichung, Taiwan
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Immunopathogenesis of membranous nephropathy: an update. Semin Immunopathol 2014; 36:381-97. [PMID: 24715030 DOI: 10.1007/s00281-014-0423-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 03/17/2014] [Indexed: 10/25/2022]
Abstract
Membranous nephropathy (MN) is a non-inflammatory organ-specific autoimmune disease which affects the kidney glomerulus, resulting in the formation of immune deposits on the outer aspect of the glomerular basement membrane, complement-mediated proteinuria, and severe renal failure in 30% of patients. In the last 10 years, substantial advances have been made in the understanding of the molecular bases of MN, with the identification of several antigens and predisposing genes in children and adults. These ground-breaking findings already have a major impact on diagnosis and monitoring and to some extent on therapies. However, there is evidence that the disease is more complex and involves a variety of antigen-antibody systems and genes involved in immune response, progression, recovery, and protective mechanisms. We herein review these recent findings which open new perspectives of research. Understanding the complex pathogenesis of MN will offer many opportunities for future therapeutic interventions and will hopefully have a major impact on patient care. New insights into the molecular mechanisms of MN may also enlighten the pathogenesis of organ-specific autoimmune diseases.
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Ronco P, Debiec H. Pathogenesis of membranous nephropathy: recent advances and future challenges. Nat Rev Nephrol 2012; 8:203-13. [DOI: 10.1038/nrneph.2012.35] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Chen SY, Chen CH, Huang YC, Chuang HM, Lo MM, Tsai FJ. Effect of IL-6 C-572G polymorphism on idiopathic membranous nephropathy risk in a Han Chinese population. Ren Fail 2011; 32:1172-6. [PMID: 20954977 DOI: 10.3109/0886022x.2010.516857] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Membranous glomerulonephritis (MGN) is viewed as an immune-mediated glomerular disease, with immunologic expression occurring in genetically susceptible persons. The cytokine interleukin-6 (IL-6) gene polymorphism is known to impair intracellular signaling pathways following adaptive immune response. Our study gauged the effects of IL-6 C-572G (rs1800796) single nucleotide polymorphism (SNP) on MGN among Taiwan's Han Chinese population, as analyzed in 265 controls and 106 MGN patients. Genotyping for IL-6 C-572G SNP was performed by restriction fragment length polymorphism assay. Data showed stark differences in genotype and allele frequency distributions at IL-6 C-572G SNP between MGN patients and controls (p = 1.6E-04 and 1.7E-04, respectively). People with C allele or with CC genotype at IL-6 C-572G SNP showed higher risk of MGN (odds ratio = 2.42 and 2.71, respectively; 95% confidence interval = 1.51-3.87 and 1.60-4.60, respectively). These point to IL-6 C-572G polymorphism as the underlying cause of MGN; polymorphism merits further investigation.
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Affiliation(s)
- Shih-Yin Chen
- Department of Medical Research, Genetic Center, China Medical University Hospital, Taichung, Taiwan, Republic of China.
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Liu YH, Chen CH, Chen SY, Lin YJ, Liao WL, Tsai CH, Wan L, Tsai FJ. Association of phospholipase A2 receptor 1 polymorphisms with idiopathic membranous nephropathy in Chinese patients in Taiwan. J Biomed Sci 2010; 17:81. [PMID: 20937089 PMCID: PMC2959017 DOI: 10.1186/1423-0127-17-81] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 10/11/2010] [Indexed: 11/29/2022] Open
Abstract
Background Idiopathic membranous nephropathy (IMN) is one of the most common forms of autoimmune nephritic syndrome in adults. The purpose of this study is to evaluate whether polymorphisms of PLA2R1 affect the development of IMN. Methods Taiwanese-Chinese individuals (129 patients with IMN and 106 healthy controls) were enrolled in this study. The selected single nucleotide polymorphisms (SNPs) in PLA2R1 were genotyped by real-time polymerase chain reaction using TaqMan fluorescent probes, and were further confirmed by polymerase chain reaction-restriction fragment length polymorphism. The roles of the SNPs in disease progression were analyzed. Results Genotype distribution was significantly different between patients with IMN and controls for PLA2R1 SNP rs35771982 (p = 0.015). The frequency of G allele at rs35771982 was significantly higher in patients with IMN as compared with controls (p = 0.005). In addition, haplotypes of PLA2R1 may be used to predict the risk of IMN (p = 0.004). Haplotype H1 plays a role in an increased risk of IMN while haplotype H3 plays a protective role against this disease. None of these polymorphisms showed a significant and independent influence on the progression of IMN and the risk of end-stage renal failure and death (ESRF/death). High disease progression in patients having C/T genotype at rs6757188 and C/G genotype at rs35771982 were associated with a low rate of remission. Conclusions Our results provide new evidence that genetic polymorphisms of PLA2R1 may be the underlying cause of IMN, and the polymorphisms revealed by this study warrant further investigation.
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Affiliation(s)
- Yu-Huei Liu
- Department of Medical Genetics and Medical Research, China Medical University Hospital, Taichung, Taiwan
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