Periodontal disease bacteria specific to tonsil in IgA nephropathy patients predicts the remission by the treatment.
Periodontal disease bacteria specific to tonsil in IgA nephropathy patients predicts the remission by the treatment.
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DOI：
10.1371/journal.pone.0081636
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Isaka Y
中科院分区：
文献类型：
--
作者：
Nagasawa Y;Iio K;Fukuda S;Date Y;Iwatani H;Yamamoto R;Horii A;Inohara H;Imai E;Nakanishi T;Ohno H;Rakugi H;Isaka Y
免疫球蛋白(Ig)A肾病是世界上最常见的原发性肾小球肾炎。一些细菌被认为是IgAN的抗原候选或发病机制，但对IgAN患者扁桃体内细菌菌群的系统分析尚未见报道。此外，这些针对IgAN的细菌可能是预测扁桃体切除联合激素冲击治疗的IgAN缓解的指标。采用变性梯度凝胶电泳法对68例IgA肾病患者和28例正常对照的扁桃体菌群进行了综合分析。我们还分析了几种针对IgAN的细菌与IgAN预后的关系。密螺旋体在24%的IgA肾病患者和7%的对照组(P = 0.062)。53%的IgA肾病患者检出塞尼氏嗜血杆菌，25%的对照组检出塞尼氏嗜血杆菌( = 0.012)。IgA肾病患者直肠弯曲杆菌阳性率为49%，对照组为14%(P = 0.002)。多因素COX比例风险模型显示密螺旋体。或直肠弯曲杆菌对蛋白尿的缓解有显著意义(危险比2.35，p = 0.019)。梅毒螺旋体感染的IgAN患者缓解率差异有统计学意义。经Kaplan-Meier分析，有直肠弯曲菌感染的患者与无直肠弯曲菌感染的患者缓解率差异有统计学意义(p = 0.037)。众所周知，这些细菌与牙周病有关。已知牙周细菌可引起免疫反应和多种疾病，也可引起IgA肾病。对IgAN的认识有助于对IgAN患者的诊断和治疗决策。
Immunoglobulin (Ig)A nephropathy (IgAN) is the most common form of primary glomerulonephritis in the world. Some bacteria were reported to be the candidate of the antigen or the pathogenesis of IgAN, but systematic analysis of bacterial flora in tonsil with IgAN has not been reported. Moreover, these bacteria specific to IgAN might be candidate for the indicator which can predict the remission of IgAN treated by the combination of tonsillectomy and steroid pulse. We made a comprehensive analysis of tonsil flora in 68 IgAN patients and 28 control patients using Denaturing gradient gel electrophoresis methods. We also analyzed the relationship between several bacteria specific to the IgAN and the prognosis of the IgAN. Treponema sp. were identified in 24% IgAN patients, while in 7% control patients (P = 0.062). Haemophilus segnis were detected in 53% IgAN patients, while in 25% control patients (P = 0.012). Campylobacter rectus were identified in 49% IgAN patients, while in 14% control patients (P = 0.002). Multiple Cox proportional-hazards model revealed that Treponema sp. or Campylobactor rectus are significant for the remission of proteinuria (Hazard ratio 2.35, p = 0.019). There was significant difference in remission rates between IgAN patients with Treponema sp. and those without the bacterium (p = 0.046), and in remission rates between IgAN patients with Campylobacter rectus and those without the bacterium (p = 0.037) by Kaplan-Meier analysis. Those bacteria are well known to be related with the periodontal disease. Periodontal bacteria has known to cause immune reaction and many diseases, and also might cause IgA nephropathy. This insight into IgAN might be useful for diagnosis of the IgAN patients and the decision of treatment of IgAN.
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