Tubular decoy receptor 2 as a predictor of prognosis in patients with immunoglobulin A nephropathy.
Tubular decoy receptor 2 as a predictor of prognosis in patients with immunoglobulin A nephropathy.
复制标题
肾小管诱饵受体 2 作为免疫球蛋白 A 肾病患者预后的预测因子
DOI：
10.1093/ckj/sfaa257
复制
发表时间：
2021-05
影响因子：
4.6
通讯作者：
He Y
中科院分区：
文献类型：
--
作者：
Dai H;Hu W;Lin L;Wang L;Chen J;He Y
摘要 背景 肾小管上皮细胞 (RTEC) 的加速衰老可能会导致免疫球蛋白 A 肾病 (IgAN) 的进展。本研究旨在确定 RTEC 衰老标记物诱饵受体 2 (DcR2) 是否可以预测 IgAN 的预后。方法 我们纳入了 105 名经活检证实患有 IgAN 的患者的回顾性队列。在肾活检时评估肾小管 DcR2 表达，牛津组织学 MEST-C 评分 [系膜细胞增多 (M)、毛细血管内增殖 (E)、节段性硬化 (S)、间质纤维化/肾小管萎缩 (T) 和新月体 (C)] 定义疾病严重程度。 IgAN 进展被定义为终末期肾病或估计肾小球滤过率 (eGFR) 下降 30% 的综合表现，使用 Kaplan-Meier 和 Cox 回归分析进行分析。结果管状DcR2在IgAN中过表达。 DCR2 和 p16 双阳性 RTEC 的数量随着肾小管萎缩/间质纤维化（T 病变）严重程度的增加而增加。肾小管DcR2表达≥25%的患者蛋白尿、T病变和eGFR较低更严重。 DCR2 阳性≥25% 的患者的累积肾脏存活率显着较低。多变量回归分析显示，≥25%的肾小管DcR2表达与IgAN中较差的eGFR斜率（肾功能下降率；P = 0.003）和综合结果的发生率（P = 0.001）显着相关。将管状 DcR2 添加到具有活检临床数据（平均动脉压、蛋白尿和 eGFR）或 MEST-C 评分的模型中，显着改善了 IgAN 进展的 5 年风险预测，这一点经受试者工作特征曲线分析证实。结论 活检时检测到的肾小管 DcR2 表达是 IgAN 进展的强有力的独立预测因子，除了已确定的风险标记之外，还可能具有预后价值。
Abstract Background Accelerated senescence of renal tubular epithelial cells (RTECs) might contribute to immunoglobulin A nephropathy (IgAN) progression. This study aimed to determine whether the RTEC senescence marker, decoy receptor 2 (DcR2), could predict prognosis in IgAN. Methods We included a retrospective cohort of 105 patients with biopsy-proven IgAN. Tubular DcR2 expression was assessed at renal biopsy and the Oxford histological MEST-C score [mesangial hypercellularity (M), endocapillary proliferation (E), segmental sclerosis (S), interstitial fibrosis/tubular atrophy (T) and crescents (C)] defined disease severity. IgAN progression was defined as a composite of end-stage renal disease or a 30% decline in the estimated glomerular filtration rate (eGFR), analyzed using Kaplan–Meier and Cox regression analyses. Results Tubular DcR2 was overexpressed in IgAN. Numbers of DcR2 and p16 double-positive RTECs increased with increasing severity of tubular atrophy/interstitial fibrosis (T lesion). Patients with ≥25% tubular DcR2 expression experienced worse proteinuria, T lesions and a lower eGFR. Cumulative renal survival was significantly lower in patients with ≥25% DcR2 positivity. Multivariate regression analyses showed that ≥25% tubular DcR2 expression was significantly associated with worse eGFR slopes (the rate of renal function decline; P = 0.003) and the incidence of the composite outcome (P = 0.001) in IgAN. The addition of tubular DcR2 to a model with clinical data at biopsy (mean arterial pressure, proteinuria and eGFR) or MEST-C score significantly improved the 5-year risk prediction of IgAN progression, as confirmed by receiver operating characteristic curve analyses. Conclusions Tubular DcR2 expression detected at biopsy was a strong independent predictor for IgAN progression and might have prognostic value in addition to established risk markers.
登录
查看更多内容
尿DcR2是糖尿病肾病患者肾小管间质损伤的新型生物标志物
DOI：
10.1152/ajprenal.00689.2016
发表时间：
2017-08-01
影响因子：
4.2
作者：
Chen, Jia;Zhang, Wei-Wei;He, Ya-Ni
通讯作者：
He, Ya-Ni
影响因子：
8
作者：
Sagiv, A.;Biran, A.;Yon, M.;Simon, J.;Lowe, S. W.;Krizhanovsky, V.
通讯作者：
Krizhanovsky, V.
影响因子：
13.2
作者：
Bartosik, LP;Lajoie, G;Cattran, DC
通讯作者：
Cattran, DC
影响因子：
19.6
作者：
Sis, B.;Tasanarong, A.;Halloran, P. F.
通讯作者：
Halloran, P. F.
影响因子：
81.5
作者：
Lai, Kar Neng;Tang, Sydney C. W.;Glassock, Richard J.
通讯作者：
Glassock, Richard J.