Objective The aim of this study was to investigate the characteristics and related functional pathways of the gut microbiota in patients with IgA nephropathy (IgAN) through metagenomic sequencing technology.Methods We enrolled individuals with primary IgAN, including patients with normal and abnormal renal function. Additionally, we recruited healthy volunteers as the healthy control group. Stool samples were collected, and species and functional annotation were performed through fecal metagenome sequencing. We employed linear discriminant analysis effect size (LEfSe) analysis to identify significantly different bacterial microbiota and functional pathways. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis was used to annotate microbiota functions, and redundancy analysis (RDA) was performed to analyze the factors affecting the composition and distribution of the gut microbiota.Results LEfSe analysis revealed differences in the gut microbiota between IgAN patients and healthy controls. The characteristic microorganisms in the IgAN group were classified as Escherichia coli, with a significantly greater abundance than that in the healthy control group (p < 0.05). The characteristic microorganisms in the IgAN group with abnormal renal function were identified as Enterococcaceae, Moraxella, Moraxella, and Acinetobacter. KEGG functional analysis demonstrated that the functional pathways of the microbiota that differed between IgAN patients and healthy controls were related primarily to bile acid metabolism.Conclusions The status of the gut microbiota is closely associated not only with the onset of IgAN but also with the renal function of IgAN patients. The characteristic gut microbiota may serve as a promising diagnostic biomarker and therapeutic target for IgAN.

The purpose of this study was to investigate the correlation between podocyte related biomarker cofilin-1 and renal function, and explore the value of cofilin-1 in predicting the risk of renal adverse prognosis in IgA nephropathy (IgAN). Patients with primary IgAN diagnosed by initial renal biopsy performed in our hospital from January 2019 to February 2022 were included. This study was a prospective cohort study. All IgAN patients were detected the expression of cofilin-1 and other related biomarkers (RhoA, NGAL) in urine by enzyme-linked immunosorbent assay (ELISA) and follow-up at least 6 months. We also collected baseline clinicopathologial data of IgAN. The decreased renal function group was defined as baseline eGFR < 60 ml/min/1.73m2. Logistic and Cox regression model were used to analyze the correlation among cofilin-1 and renal prognosis. 133 IgAN patients were included, with a male-to-female ratio of 1.25:1 and an age of 37.67 ± 13.78 years, as well as an average of eGFR was 71.63 (40.42,109.33) ml/min/1.73m2. 56 patients (42.1

Objective:To investigate the clinical and pathological characteristics of primary IgA nephropathy (IgAN) patients with dyslipidemia in order to explore the effect of blood lipids on the prognosis of IgAN kidney.Methods:The data of patients with primary IgAN diagnosed by renal biopsy in our hospital from January 1, 2000 to December 31, 2018 were retrospectively analyzed. The follow-up was conducted until January 1, 2020. The end point of follow-up was end-stage renal disease (ESRD) or that the estimated glomerular filtration rate (eGFR) decreased by ≥ 50%. Those who did not reach the end point were followed up for at least 1 year. According to the baseline blood lipid level at the time of renal biopsy, IgAN patients were divided into normal blood lipid group (331 cases) and abnormal blood lipid group (450 cases) by the diagnostic criteria of abnormal blood lipid. The abnormal blood lipid group was further divided into four single-indicator subgroups: high cholesterol group, high triglyceride group, high LDL group and low HDL group. Pathological score was assessed according to the Oxford classification, and the risk factors affecting the prognosis of IgAN patients were analyzed by logistic regression analysis and Cox regression model methods. Kaplan-Meier survival curve was used to compare the difference in survival rate of IgAN patients between the abnormal blood lipid group and the normal blood lipid group.Results:The age, body mass index (BMI), blood pressure, serum creatinine, serum uric acid and urine protein in the abnormal blood lipid group were higher than those in the normal blood lipid group, while the serum albumin and eGFR were lower than those in the normal blood lipid group (all P<0.05). According to the Oxford classification score, compared with other groups, the low HDL group showed that the degree of renal tubulointerstitial lesions of IgAN was more severe (P<0.05). Logistic regression analysis showed that old age (OR 1.044, 95%CI: 1.023-1.066, P<0.001), high mean arterial pressure (OR 1.025, 95%CI: 1.008-1.043, P=0.004), low hemoglobin (OR 0.963, 95%CI: 0.950-0.976, P<0.001), high triglyceride (OR 1.008, 95%CI: 1.005-1.010, P<0.001), low HDL (OR 0.546, 95%CI: 0.311-0.959, P=0.035), high 24-hour urine protein (OR 1.185, 95%CI: 1.039-1.352, P=0.011), and high Oxford classification T-score (OR 9.115, 95%CI: 5.297-15.685, P<0.001) were the influencing factors for the decline of IgAN baseline renal function. Multivariate Cox regression analysis showed that low hemoglobin (OR 0.965, 95%CI: 0.949-0.980, P<0.001), low baseline eGFR (OR 0.984, 95%CI: 0.973-0.996, P=0.008), high 24-hour urine protein (OR 1.151, 95%CI: 1.043-1.271, P=0.005), high Oxford classification T-score (OR 1.680, 95%CI: 1.033-2.732, P=0.036), and high triglyceride (OR 1.177, 95%CI: 1.038-1.334, P=0.011) were risk factors for the poor prognosis of IgAN kidney. Kaplan-Meier survival curve analysis showed that the median renal survival time of IgAN patients of the abnormal blood lipid group in the follow-up was significantly shorter than that in the normal blood lipid group (χ2=8.316, P=0.004).Conclusion:HDL was associated with the renal tubulointerstitial lesions, and triglyceride was a risk factor for the poor renal prognosis of IgAN patients. In clinical practice, blood lipid monitoring in IgAN patients should be strengthened.

目的 研究伴足突融合的IgA肾病(IgAN)患者的临床病理特征,探讨足突融合对IgA肾病患者肾功能的影响.方法 回顾性分析我院219例IgA肾病患者资料,根据电镜下足突病变分为足突广泛融合组(融合≥50％)40例(18.3％)和足突无明显病变组(包括无病变和<50％融合)179例(81.7％).结果 足突广泛融合组与无明显病变组比较,血肌酐、尿素氮、尿酸、舒张压、胆固醇、甘油三酯、低密度脂蛋白(LDL)及尿蛋白定量更高,血白蛋白及肾小球滤过率估值(eGFR)更低.舒张压、尿素氮及LDL升高是足突广泛融合的独立危险因素.logistic结果显示足突广泛融合是IgA肾病肾功能异常的独立危险因素(P<0.05).结论 足突广泛融合的IgAN患者临床表现更重,足突广泛融合是IgA肾病患者肾功能的重要影响因素.

目的:探讨Hedgehog通路中关键转录因子Gli2对顺铂诱导的体外急性肾损伤(AKI)肾小管上皮细胞凋亡及纤维化的影响作用.方法:将肾小管上皮细胞NRK-52E分成沉默空载对照组、沉默Gli2组、过表达空载对照组及过表达Gli2组,然后予顺铂刺激干预处理后用流式细胞仪测细胞凋亡情况,并提取细胞总RNA用实时荧光定量PCR(RT-qPCR)法检测Hedgehog通路重要因子、AKI及纤维化标志物的表达.结果:顺铂可呈剂量依赖性诱导NRK52E细胞中Gli2的mRNA表达(P<0.05).与沉默空载组相比,沉默Gli2组可减少顺铂干预后NRK52E细胞凋亡率,下调纤维化和AKI标志物,下调Hedgehog通路因子Smo表达(均P<0.05);过表达Gli2组可增加顺铂干预后NRK52E细胞凋亡率,上调纤维化标志物(均P<0.05).结论:Gli2可影响顺铂诱导的肾小管上皮细胞凋亡及纤维化,Hedgehog/Gli2通路参与调控AKI的肾小管损伤及纤维化变.