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Wei L. Exploring the potential mechanisms of Shiwei Hezi pill against nephritis based on the method of network pharmacology. Front Pharmacol 2023; 14:1178734. [PMID: 37361210 PMCID: PMC10288138 DOI: 10.3389/fphar.2023.1178734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
Objective: We aimed to reveal the potential active ingredients, targets and pathways of Shiwei Hezi pill (SHP) in the treatment of nephritis based on systematic network pharmacology. Methods: The online database was used to screen the common targets of SHP and nephritis, and the interaction between targets was analyzed. Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed using the Bioinformatics website. Molecular docking was carried out to verify the correlation between core ingredients and key targets. Cytoscape 3.6.1 was applied to perform protein-protein interactions (PPT) network construction and data visualization. Results: A total of 82 active ingredients in SHP were screened, and 140 common targets of SHP and nephritis were obtained. Our results demonstrated that TNF, AKT1 and PTGS2 might be the key targets of SHP in the treatment of nephritis. GO enrichment analysis yielded 2163 GO entries (p < 0.05), including 2,014 entries of the biological process (BP) category, 61 entries of the cell composition (CC) category and 143 entries of the molecular function (MF) category. KEGG pathway enrichment analysis produced 186 signaling pathways (p < 0.05), involving the AGE-RAGE, IL-17and TNF signaling pathways. The results of molecular docking showed that three active ingredients in SHP (quercetin, kaempferol and luteolin) could effectively bind to the TNF, AKT1 and PTGS2 targets. Conclusion: The effective active ingredients in SHP may regulate multiple signaling pathways through multiple targets, thereby exhibiting a therapeutic effect on nephritis.
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Zhao Q, Dai H, Hu Y, Jiang H, Feng Z, Liu W, Dong Z, Tang X, Hou F, Rui H, Liu B. Cytokines network in primary membranous nephropathy. Int Immunopharmacol 2022; 113:109412. [DOI: 10.1016/j.intimp.2022.109412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/24/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
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3
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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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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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5
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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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Kamyshova ES, Bobkova IN, Gorelova IA, Каkhsurueva PA, Filatova EE. Genetic determinants of the development and course of membranous nephropathy. TERAPEVT ARKH 2019; 90:105-111. [PMID: 30701913 DOI: 10.26442/terarkh2018906105-111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults and is classified as either primary (idiopatic) or secondary MN according to underlying etiology (the later result from some known disease such as systemic autoimmune diseases, infections, malignancies, drugs, etc). In recent years, phospholipase A2 receptor 1 (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A) were identified as two major podocytic antigens involved in the pathogenesis of idiopatic MN (IMN). And the discovery of circulating antibodies specific for these target antigens has transformed the diagnostic workup and significally improved management of IMN. However why do such antibodies develop is not conclusively established. The role of underlying genetic factors is discussed. The review presents the results of recent studies, that have shown significant associations of specific genetic factors (particularly human leucocyte antigen class II and PLA2R1 genes) with IMN.
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Affiliation(s)
- E S Kamyshova
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
| | - I N Bobkova
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
| | - I A Gorelova
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
| | - P A Каkhsurueva
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
| | - E E Filatova
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
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7
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Hou Y, Bai L, Jiang N, Yao Z, Xue L, Yu B. Screening of TNF-α gene polymorphisms in patients with extremity chronic osteomyelitis in China. Per Med 2018; 15:395-401. [PMID: 30259788 DOI: 10.2217/pme-2018-0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM This study aims to investigate the link between TNF-α gene SNPs and patients with extremity chronic osteomyelitis in China. METHODOLOGY Our study included 433 subjects, composed of 233 extremity chronic osteomyelitis patients and 200 controls. Six single-nucleotide polymorphisms (rs1799964, rs1800630, rs1799724, rs1800750, rs1800629 and rs361525) in TNF-α gene were detected by the SNaPshot genotyping method. RESULTS Significant genotype distribution of rs1799964 was identified between patients and healthy controls (p = 0.045). In addition, statistical difference was found between rs1799964 SNP and the susceptibility to extremity chronic osteomyelitis (p = 0.044). CONCLUSION We reported for the first time that TNF-α gene SNP rs1799964 contributes to the elevated venture of extremity chronic osteomyelitis in China.
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Affiliation(s)
- Yilong Hou
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Lang Bai
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Nan Jiang
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.,Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Zilong Yao
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Li Xue
- 8th Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, PR China
| | - Bin Yu
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.,Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
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8
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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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The Levels of Tumor Necrosis Factor-alpha (TNF-α G-308A) Genes and Macrophage Migration Inhibitory Factor (MIF G173C) Polymorphism in the Idiopathic Membranous Nephropathy(IMN) in Adults. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.2.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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10
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Zhang XD, Cui Z, Zhao MH. The Genetic and Environmental Factors of Primary Membranous Nephropathy: An Overview from China. KIDNEY DISEASES 2018; 4:65-73. [PMID: 29998121 DOI: 10.1159/000487136] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/18/2018] [Indexed: 01/10/2023]
Abstract
Background Primary membranous nephropathy (pMN) is the most common cause of nephrotic syndrome in adults. The discovery of the 2 autoantigens, M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A), has defined pMN as an autoimmune disease. A remarkable increase in the frequency of pMN in primary glomerular disease was witnessed in China. The genetic and environmental contributors to disease susceptibility have been investigated in these patients. Summary We reviewed recent publications in genetic and environmental studies of pMN, focusing mainly on those undertaken in China. Following a genome-wide association study, the gene-gene interaction between the 2 most significant risk factors, PLA2R1 and DQA1, was validated in Chinese patients with MN. Fine mapping on human leukocyte antigen (HLA) locus found that DRB1*1501 and DRB1*0301 were risk alleles. Three amino acid residues on positions 13 and 71 of HLA-DRβ1 chain may confer the susceptibility to pMN by presenting T-cell epitopes on PLA2R. Another study found that DRB3*0202 was the most likely culprit allele for the signal at DRB1*0301. One environmental risk factor for pMN has been identified as the long-term exposure to high levels of PM2.5 in Chinese patients with MN. Each 10 μg/m3 increase in PM2.5 concentration was associated with 14% higher odds for pMN in the regions with PM2.5 above 70 μg/m3. Key Message A gene-environment interaction is suspected as an underlying mechanism for the increasing trend of pMN in China.
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Affiliation(s)
- Xiao-Dan Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Zhao Cui
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
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Huang YS, Fu SH, Lu KC, Chen JS, Hsieh HY, Sytwu HK, Wu CC. Inhibition of tumor necrosis factor signaling attenuates renal immune cell infiltration in experimental membranous nephropathy. Oncotarget 2017; 8:111631-111641. [PMID: 29340080 PMCID: PMC5762348 DOI: 10.18632/oncotarget.22881] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/23/2017] [Indexed: 12/03/2022] Open
Abstract
Idiopathic membranous nephropathy (MN) is an autoimmune-mediated glomerulonephritis and the most common cause of idiopathic nephrotic syndrome in adult humans. A tumor necrosis factor α (TNF-α)-mediated inflammatory response via TNF receptor 1 (TNFR1) and TNFR2 has been proposed as a pathogenic factor. In this study, we assessed the therapeutic response to blocking TNF signaling in experimental MN. Murine MN was induced experimentally by cationic bovine serum albumin (cBSA); phosphate-buffered saline was used in control mice. In MN mice, TNF was inhibited by etanercept blocking of TNFR1/TNFR2 or the preligand assembly domain fusion protein (PLAD.Fc), a small fusion protein that can preferentially block TNFR1 signaling. Disease severity and possible mechanisms were assessed by analyzing the metabolic and histopathology profiles, lymphocyte subsets, immunoglobulin production, oxidative stress, and apoptosis. cBSA-induced MN mice exhibited typical nephrotic syndrome and renal histopathology. MN mice given etanercept or PLAD.Fc did not exhibit significant reduction of proteinuria, amelioration of glomerular lesions, or attenuation of immune complex deposition. Immune cell subsets, serum immunoglobulin levels, production of reactive oxygen species, and cell apoptosis in the kidney were not altered by TNF inhibition. By contrast, MN mice receiving etanercept or PLAD.Fc exhibited significantly decreased infiltration of immune cells into the kidney. These results show that the therapeutic effects of blocking TNFR1 and/or TNFR2 signaling in experimental MN are not clinically effective. However, TNF signaling inhibition significantly attenuated renal immune cell infiltration in experimental MN.
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Affiliation(s)
- Yen-Sung Huang
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Shin-Huei Fu
- Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Kuo-Cheng Lu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Division of Nephrology, Department of Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Jin-Shuen Chen
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-Yi Hsieh
- Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Huey-Kang Sytwu
- Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Chao Wu
- Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan.,Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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12
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Qin XS, Liu JH, Lyu GT, Peng ML, Yang FN, Qin DC, Li YZ, Liu Y. Variants in the Promoter Region of HLA-DQA1 were Associated with Idiopathic Membranous Nephropathy in a Chinese Han Population. Chin Med J (Engl) 2017; 130:1677-1682. [PMID: 28685717 PMCID: PMC5520554 DOI: 10.4103/0366-6999.209884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Idiopathic membranous nephropathy (IMN) is an autoimmune disease and the leading cause of adult nephritic syndrome. HLA-DQA1 had been identified to be associated with IMN in Europeans and the result was replicated in Chinese Han population. In this study, six single nucleotide polymorphisms (SNPs) in the promoter of HLA-DQA1 and other two SNPs with IgA nephropathy were included for the association analysis. Methods: The SNPs were genotyped in 509 patients and 601 controls by the MassArray iPLEX. The quantification of anti-phospholipase A2 receptor (PLA2R) antibodies in sera of IMN patients was performed by anti-PLA2R ELISA (IgG) kit. Results: After analysis, four SNPs were significantly associated with IMN, with rs2187668 and rs28383345 as the top two signals (P = 8.42×10-5 and 2.48×10-5, respectively). Even under dominant model, the two SNPs were still significantly associated with IMN (P = 3.50×10-3 for rs28383345 and P = 6.55×10-5 for rs2187668). After conditional study with rs2187668, rs28383345 was the only variant significantly correlated with IMN after Bonferroni correction (P = 0.016). The minor alleles of the two SNPs were also mutually exclusive in our cohort. This indicated that the two SNPs were independently associated with IMN in Chinese Han population. Levels of anti-PLA2R autoantibodies were correlated with the genotypes of the two SNPs, but not significantly (P>0.05). Conclusions: Our results revealed that a novel independent variant in the promoter of HLA-DQA1 was associated with IMN in Chinese Han population. The locus possessed regulatory role according to the data of RegulomeDB. The exact role of the SNPs on the expression of HLA-DQA1 needs further investigation.
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Affiliation(s)
- Xiao-Song Qin
- Department of Medical Laboratory, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110011, China
| | - Jian-Hua Liu
- Department of Medical Laboratory, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110011, China
| | - Guan-Ting Lyu
- Department of Blood Transfusion, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Meng-Le Peng
- Department of Medical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Fu-Ning Yang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100005, China
| | - Dong-Chun Qin
- Department of Medical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Yong-Zhe Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100005, China
| | - Yong Liu
- Department of Medical Laboratory, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110011, China
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Protein Array-Based Detection of Proteins in Kidney Tissues from Patients with Membranous Nephropathy. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7843584. [PMID: 28337458 PMCID: PMC5350302 DOI: 10.1155/2017/7843584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/25/2017] [Accepted: 01/29/2017] [Indexed: 11/26/2022]
Abstract
Membranous nephropathy (MN) is an autoimmune inflammatory disease in which proteins related with plenty of biological processes play an important role. However, the role of these proteins in the pathogenesis of MN is still unclear. This study aimed to screen differential proteins in kidney tissue samples from MN patients by using protein arrays and determine the pathways involved in the pathogenesis of MN. This study first tested a quantitative protein array (QAH-INF-3) and two semiquantitative protein arrays (L-493 and L-507) with normal renal tissue and identified L-493 as the most appropriate assay to compare protein levels between MN tissues and normal control tissues. The L-493 array identified 66 differentially expressed proteins (DEPs) that may be associated with MN. The gene oncology (GO) and protein-protein interaction (PPI) analyses revealed several processes potentially involved in MN, including extracellular matrix disassembly and organization, cell adhesion, cell-cell signaling, cellular protein metabolic process, and immune response (P < 0.05). We suggest that these different pathways work together via protein signaling and result in the pathogenesis and progression of MN.
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14
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Xu X, Wang G, Chen N, Lu T, Nie S, Xu G, Zhang P, Luo Y, Wang Y, Wang X, Schwartz J, Geng J, Hou FF. Long-Term Exposure to Air Pollution and Increased Risk of Membranous Nephropathy in China. J Am Soc Nephrol 2016; 27:3739-3746. [PMID: 27365535 DOI: 10.1681/asn.2016010093] [Citation(s) in RCA: 262] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 03/21/2016] [Indexed: 01/26/2023] Open
Abstract
The effect of air pollution on the changing pattern of glomerulopathy has not been studied. We estimated the profile of and temporal change in glomerular diseases in an 11-year renal biopsy series including 71,151 native biopsies at 938 hospitals spanning 282 cities in China from 2004 to 2014, and examined the association of long-term exposure to fine particulate matter of <2.5 μm (PM2.5) with glomerulopathy. After age and region standardization, we identified IgA nephropathy as the leading type of glomerulopathy, with a frequency of 28.1%, followed by membranous nephropathy (MN), with a frequency of 23.4%. Notably, the adjusted odds for MN increased 13% annually over the 11-year study period, whereas the proportions of other major glomerulopathies remained stable. During the study period, 3-year average PM2.5 exposure varied among the 282 cities, ranging from 6 to 114 μg/m3 (mean, 52.6 μg/m3). Each 10 μg/m3 increase in PM2.5 concentration associated with 14% higher odds for MN (odds ratio, 1.14; 95% confidence interval, 1.10 to 1.18) in regions with PM2.5 concentration >70 μg/m3 We also found that higher 3-year average air quality index was associated with increased risk of MN. In conclusion, in this large renal biopsy series, the frequency of MN increased over the study period, and long-term exposure to high levels of PM2.5 was associated with an increased risk of MN.
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Affiliation(s)
- Xin Xu
- Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China
| | - Guobao Wang
- Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China
| | - Nan Chen
- Renal Division, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Lu
- Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China
| | - Sheng Nie
- Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China
| | - Gang Xu
- Renal Division, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Zhang
- Renal Division, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu, China
| | - Yang Luo
- Renal Division, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yongping Wang
- Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China
| | - Xiaobin Wang
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Joel Schwartz
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Jian Geng
- Department of Renal Pathology, King Medical Diagnostics Center, Guangzhou, China; and .,Department of Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Fan Fan Hou
- Renal Division, Nanfang Hospital, Southern Medical University, The National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangzhou, China;
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Singh K, Prasad KN, Mishra P, Singh SK, Kharwar NK, Prasad N, Gupta A, Srivastava JK. Association of tumour necrosis factor-α polymorphism in patients with end stage renal disease. Nephrology (Carlton) 2015; 20:387-91. [DOI: 10.1111/nep.12398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Kamini Singh
- Department of Microbiology; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
- Amity Institute of Biotechnology; Amity University; Lucknow India
| | - Kashi Nath Prasad
- Department of Microbiology; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
| | - Priyanka Mishra
- Department of Microbiology; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
| | - Satyendra Kumar Singh
- Department of Microbiology; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
| | - Nagendra Kumar Kharwar
- Department of Microbiology; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
| | - Narayan Prasad
- Department of Nephrology; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
| | - Amit Gupta
- Department of Nephrology; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow India
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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: 84] [Impact Index Per Article: 9.3] [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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Giacomelli M, Kumar R, Tampella G, Ceffa S, Bontempelli M. IL-4, IL-10 and TNF-<i>α</i> Polymorphisms in Idiopathic Membranous Nephropathy (IMN). ACTA ACUST UNITED AC 2015. [DOI: 10.4236/oji.2015.55019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Urokinase gene 3'-UTR T/C polymorphism is associated with malignancy and ESRD in idiopathic membranous nephropathy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:425095. [PMID: 24822208 PMCID: PMC4009112 DOI: 10.1155/2014/425095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/23/2014] [Accepted: 03/24/2014] [Indexed: 11/17/2022]
Abstract
Idiopathic membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults, and 25% of MN patients proceed to ESRD. Urokinase plasminogen activator (uPA) may play an important role in reducing renal fibrosis. This study was conducted to clarify the relationship between uPA gene polymorphisms and clinical manifestations of MN. We recruited 91 biopsy-diagnosed MN patients and 105 healthy subjects. Genotyping of uPA gene 3'-UTR T/C polymorphism was performed by polymerase chain reaction methods. The genotype distribution had no effect on the development of MN. Thirteen patients (15.9%; P = 0.008) acquired malignancies and seventeen (20.7%; P = 0.006) patients progressed to ESRD with the C/C genotype, but no patients with the T/C genotype did. In conclusion, we demonstrated that the presence of the uPA gene 3'-UTR C/C genotype was associated with ESRD as well as acquired malignancies in MN patients. These findings should prompt specific considerations for the treatment of MN patients to maintain a balance between treating disease entities and protecting the immune system from cancers.
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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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Chen YT, Wei CC, Ng KL, Chen CH, Chan CJ, Chen XX, Chang YY, Chen SY, Tsai FJ. Toll-like receptor 9 SNPs are susceptible to the development and progression of membranous glomerulonephritis: 27 years follow-up in Taiwan. Ren Fail 2013; 35:1370-5. [PMID: 23964786 DOI: 10.3109/0886022x.2013.828264] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to determine whether toll-like receptors 9 (TLR9) gene polymorphisms (rs352139 and rs352140) were markers of susceptibility to the development and progression of membranous nephropathy (MGN) in Taiwanese patients. The polymorphisms were investigated by polymerase chain reaction in 397 Taiwanese individuals (134 MGN patients and 263 controls). Patients with malignancy, chronic infectious diseases, lupus nephritis, or drug-induced secondary MGN were excluded from the study. Data showed AA genotype at rs352139 SNP or GG genotype at rs352140 SNP may indicate higher risk for MGN (odds ratio [OR] = 1.55; 95% confidence interval [CI] = 1.02-2.35, at rs352139 SNP; OR = 1.57; 95% CI = 1.03-2.39, at rs352140 SNP). However, MGN patients with A-G haplotype were susceptible for decreased creatinine clearance rate and for seriously tubule-interstitial fibrosis. The result suggests for the first time that TLR9 (rs352139 and rs352140) polymorphisms may contribute to the development and progression of MGN.
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Affiliation(s)
- Yng-Tay Chen
- Department of Medical Research, Genetics Center, China Medical University Hospital , Taichung , Taiwan
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21
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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, Chan CJ, Hsieh YY, Yu MC, Tsai CH, Tsai FJ. Association of STAT4 polymorphisms with susceptibility to primary membranous glomerulonephritis and renal failure. Clin Chim Acta 2011; 412:1899-904. [PMID: 21740896 DOI: 10.1016/j.cca.2011.06.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 06/05/2011] [Accepted: 06/11/2011] [Indexed: 01/06/2023]
Abstract
BACKGROUND Membranous glomerulonephritis (MGN) is one of common causes of idiopathic nephrotic syndrome in adults, and 25% of MGN patients proceed to end-stage renal disease. STAT4 gene polymorphisms have been reported to be associated with many inflammatory diseases. The objective of this study was to clarify the relationship between STAT4 gene polymorphisms and the pathogenesis of MGN. METHODS We investigated the association of three STAT4 gene polymorphisms (rs3024912, rs3024908, and rs3024877) with the susceptibility to MGN in 403 Taiwanese populations (138 MGN patients and 265 controls). RESULTS The results indicated that the statistically significant difference in genotype frequency distribution was found at rs3024908 SNP in MGN patients and control groups (p=0.014). In addition, the individuals with the GG genotype at rs3024912 SNP may have a higher risk in kidney failure of MGN patients (adjusted odds ratio [OR]=3.255; 95% confidence interval [CI]=1.155-9.176, p=0.026). CONCLUSIONS Our data provide a new information that the STAT4 (rs3024912 and rs3024908) polymorphisms may be the underlying cause of MGN, and these 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.
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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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Chen WC, Chen SY, Chen CH, Chen HY, Lin YW, Ho TJ, Huang YC, Shen JL, Tsai FJ, Chen YH. Lack of association between transient receptor potential cation channel 6 polymorphisms and primary membranous glomerulonephritis. Ren Fail 2010; 32:666-72. [PMID: 20540633 DOI: 10.3109/0886022x.2010.485289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Membranous glomerulonephritis (MGN) is one common cause of idiopathic nephrotic syndrome. Transient receptor potential cation channel 6 (TRPC6) has been identified as causing a familial form of progressive focal and segmental glomerulosclerosis. The objective was to clarify the relationship between TRPC6 polymorphisms and MGN. We recruited a cohort of 134 biopsy-diagnosed MGN patients and 265 healthy subjects. Genotyping of TRPC6 polymorphisms was performed using allele-specific polymerase chain reaction methods. We then analyzed associations between TRPC6 gene polymorphisms and clinical manifestations and pathogenesis of MGN. There was no statistically significant difference of TRPC6 gene rs3824935 C/T, rs17096918 C/T, and rs4326755 A/G polymorphisms between controls and patients with MGN. There was no statistical significance of allele frequencies in these two groups. The characteristics of clinical parameters in TRPC6 gene (rs3284935) C/T polymorphism revealed no difference except proteinuria (p < 0.0005) between CC and non-CC genotype in MGN patients. Besides, no apparent statistically significant differences of rs17096918 C/T (TT and non-TT) and rs4326755 A/G (AA and non-AA) polymorphisms between genotypes were found in the clinical parameters. There is no different genotype distribution between normal controls and patients with MGN of TRPC6 gene. The data also show that TRPC6 gene may not be associated with disease clinical course of MGN.
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Affiliation(s)
- Wen-Chi Chen
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Lo WY, Chen SY, Wang HJ, Shih HC, Chen CH, Tsai CH, Tsai FJ. Association between genetic polymorphisms of the NPHS1 gene and membranous glomerulonephritis in the Taiwanese population. Clin Chim Acta 2010; 411:714-8. [PMID: 20138859 DOI: 10.1016/j.cca.2010.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 02/01/2010] [Accepted: 02/01/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND Membranous glomerulonephritis (MGN) is one of the most common causes of nephrotic syndrome in adults. NPHS1 encoding nephrin is a transmembrane protein of the immunoglobulin family. We clarified the relationship between NPHS1 gene polymorphisms and the susceptibility or progression of MGN. METHODS We recruited a cohort of 132 biopsy-diagnosed MGN patients and 257 healthy subjects. Genotyping of three SNPs (rs401824, rs437168 and rs3814995) at chromosome positions 41034749 (5'UTR), 41026259(exon17) and 41034052 (exon 3) was performed using a Taqman SNP genotyping assay. RESULTS There was a significant difference in genotype frequency distribution of rs437168 polymorphism between MGN patients and controls. The results also showed that the frequency of the G allele was significantly higher in the patient group. Among the polymorphisms rs437168, rs401824 and rs3814995, no significant haplotype was shown in MGN patients. A stratified analysis revealed that a high disease progression in the AA genotype of rs401824 and GG genotype of rs437168 patients were associated with a low rate of remission. CONCLUSIONS The presence of the different genotypes of NPHS1 was associated with susceptibility of MGN and the remission of proteinuria during disease progression after the therapy.
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Affiliation(s)
- Wan-Yu Lo
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
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Lionaki S, Siamopoulos K, Theodorou I, Papadimitraki E, Bertsias G, Boumpas D, Boletis J. Inhibition of tumour necrosis factor alpha in idiopathic membranous nephropathy: a pilot study. Nephrol Dial Transplant 2009; 24:2144-50. [DOI: 10.1093/ndt/gfn771] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chen CH, Shu KH, Wen MC, Chen KJ, Cheng CH, Lian JD, Wu MJ, Yu TM, Tsai FJ. Impact of plasminogen activator inhibitor-1 gene polymorphisms on primary membranous nephropathy. Nephrol Dial Transplant 2008; 23:3166-73. [PMID: 18495745 DOI: 10.1093/ndt/gfn258] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Idiopathic membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults, and 25% of MN patients proceed to end-stage renal disease. Plasminogen activator inhibitor type 1 (PAI-1) activity plays an important role in renal fibrosis. The objective of this study was to clarify the relationship between PAI-1 gene polymorphisms and the progression of MN-associated pathologies. METHODS We recruited a cohort of 104 biopsy-diagnosed MN patients and 142 healthy subjects that served as controls. Genotyping of PAI-1 gene polymorphisms was performed using allele-specific polymerase chain reaction methods. We then analysed associations between PAI-1 gene 4G/5G polymorphisms and clinical manifestations and progression of MN. RESULTS The genotype distribution had no effect on the development of MN. The last measured creatinine clearance in MN patients having the 4G/4G genotype was significantly lower than in patients having the 4G/5G or 5G/5G genotypes (43.6 +/- 33.6, 55.8 +/- 44.3 and 73.3 +/- 29.8 ml/min, respectively, P = 0.008). Coronary artery diseases were more prevalent in patients having the 4G5G (14/32%) and 4G4G genotypes (4/11%) than in those having the 5G5G genotype (1/5%, P = 0.008). Peripheral vascular events were more prevalent in patients having the 4G5G (18/41%) and 4G4G (6/16%) genotypes than in those having the 5G5G genotype (3/14%, P = 0.021). Disease progression occurred more frequently in patients having the 4G4G (20/53%) and 4G5G (25/57%) genotypes compared with those having the 5G5G genotype (5/23%, P = 0.026). CONCLUSIONS The presence of the 4G allele was associated with renal deterioration and increased cardiovascular as well as other vascular events in MN patients. These findings should prompt specific considerations for the treatment of MN in patients having the 4G4G genotype.
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Affiliation(s)
- Cheng-Hsu Chen
- Division of Nephrology, Taichung Veterans General Hospital, Taiwan
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Bockenhauer D, Debiec H, Sebire N, Barratt M, Warwicker P, Ronco P, Kleta R. Familial membranous nephropathy: an X-linked genetic susceptibility? Nephron Clin Pract 2007; 108:c10-5. [PMID: 18075275 DOI: 10.1159/000112466] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Accepted: 09/16/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Membranous nephropathy (MN) is the most common histological diagnosis in adults with nephrotic syndrome and a leading cause of end-stage kidney failure from glomerulonephritis. Little is known about the underlying aetiology, although anti-glomerular antibodies have been implicated. No specific underlying genetic defect has yet been identified. METHODS In a family with four members in three generations affected by primary MN, the serum of affected members and their mothers were assessed for anti-glomerular antibodies. RESULTS All four affected are male and connected through the maternal line, indicative of X-linked inheritance. Age of onset of nephrotic syndrome varied between 1 and 67 years of age, suggesting that a potential underlying gene may confer a genetic predisposition to MN, but other factors, genetic or environmental, are necessary to trigger the disease. Serologic studies revealed antibodies against glomerular and peritubular endothelial cells in the mother of the youngest patient. CONCLUSIONS We have identified the largest reported family with a potential X-linked susceptibility to MN. Foeto-maternal alloimmunization may have triggered the disease in the youngest individual. Considering that the majority of patients with sporadic MN are male, identification of an X-linked predisposing factor may have implications well beyond this family and could provide a target for treatment.
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Thibaudin D, Thibaudin L, Berthoux P, Mariat C, Filippis JP, Laurent B, Alamartine E, Berthoux F. TNFA2 and d2 alleles of the tumor necrosis factor alpha gene polymorphism are associated with onset/occurrence of idiopathic membranous nephropathy. Kidney Int 2007; 71:431-7. [PMID: 17213876 DOI: 10.1038/sj.ki.5002054] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Idiopathic membranous nephropathy (IMN) has a strong association with the major histocompatibility complex HLA B8DR3(17)DQ2 haplotype. The tumor necrosis factor (TNF)A gene is located within the major histocompatibility complex region on chromosome 6. We have studied the influence of two functional polymorphisms; the -308 (promoter region) and the TNFd microsatellites on initiation and/or progression of IMN. This was a case-control study comparing data from 100 Caucasians patients (67 male subjects; 67%) with IMN to 232 Caucasians local controls (171 male subjects; 74%). We have analyzed genotypes and alleles distributions and the role of these polymorphisms in disease progression towards end-stage renal failure or patient death. For -308 TNFA polymorphism, distribution of genotypes was significantly different between IMN and controls (chi(2)=16.25; P=0.0003): the A2 allele frequency was 28.0% in IMN vs 15.3% in controls (chi(2)=14.57; P=0.0001). For TNFd polymorphism, alleles distribution (from d1 to d7) was also significantly different between IMN and controls (chi(2)=56.74; P<0.0001) with both diminished d3 allele frequency (chi(2)=27.30; P<0.0001; Pc=0.001) and increased d2 allele frequency (chi(2)=29.95; P<0.0001; Pc=0.001) in IMN. We could not isolate any significant and independent influence of these different genotypes on IMN disease progression. The TNFA2 and TNFd2 alleles were strongly associated with occurrence/initiation of IMN and should be considered as susceptibility genes for this disease.
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Affiliation(s)
- D Thibaudin
- Nephrology, Dialysis and Renal Transplantation Department, North University Hospital, Saint-Etienne, France
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30
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Current World Literature. Curr Opin Nephrol Hypertens 2007; 16:52-7. [PMID: 17143072 DOI: 10.1097/mnh.0b013e32801271d6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Manchanda PK, Kumar A, Kaul A, Mittal RD. Correlation between a gene polymorphism of tumor necrosis factor-alpha (G/A) and end-stage renal disease: a pilot study from north India. Clin Chim Acta 2006; 370:152-7. [PMID: 16545788 DOI: 10.1016/j.cca.2006.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 02/04/2006] [Accepted: 02/06/2006] [Indexed: 10/25/2022]
Abstract
BACKGROUND Patients with chronic kidney disease manifest an inflammatory state in comparison to healthy individuals. Tumor necrosis factor-alpha (TNF-alpha) is a potent pro-inflammatory cytokine involved in initiation and progression of renal injury. We examined the 2-promoter region polymorphism of TNF-alpha gene G to A at -308 and at +488 sites in end-stage renal disease (ESRD) subjects. METHODS The TNF-alpha -308 G/A and +488 G/A polymorphisms were genotyped in 231 patients aged 36.5+/-10, and in 180 matched controls (34.96+/-11.3) by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and amplification refractory mutation system (ARMS-PCR) method, respectively. RESULTS The genotypic distribution of TNF-alpha -308 and +488 were significantly different between patients and controls (P<0.001 and P<0.006), respectively. The AA genotype was more frequent in ESRD patients than controls for both the sites (42% vs. 2.8% and 17.3% vs. 2.2%), respectively. The allelic frequency of TNF-alpha A was also higher in cases than in controls for both the sites (P<0.001; OR=2.96; 95% CI=2.228-3.945 and P<0.013; OR=1.422; 95% CI=1.078-1.876). Significant difference was observed for haplotype frequency distribution between ESRD patients and controls and 'A-G#' haplotype showed >9-fold higher risk (OR=9.886, 95% CI=4.408-22.172). The two polymorphisms were in linkage disequilibrium in the control group (D'=0.8047, P<0.001). CONCLUSION Both the variants of TNF-alpha (-308 and +488) polymorphism had significant association and may thus be a strong predisposing risk factor for ESRD in a cohort of north Indian population. Further, individuals with haplotypes A-G# may be at higher risk for ESRD.
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