OMEGA 3 FATTY ACIDS IN IGA NEPHROPATHY

IgA肾病是全球最常见的肾小球肾炎， 其特征在于可变的临床病程，进展为慢性 20 - 40%的患者患有肾病。 鱼油补充剂 显著延缓了蛋白尿组肾功能的恢复 在最近完成的临床试验中， 由马约肾病协作研究组进行。 目前它 很难确定最有可能受益于 这种治疗，因为很少有临床病理学参数， 提供个体患者的预后信息。 以来 毛细血管内增殖和细胞外基质沉积是 IgA肾病的主要形态学改变，我们建议 确定评估这些参数的新方法是否可以提供 提供额外的预后信息，并为治疗提供基础。 在新诊断的患者中。 肾小球和 间质增生在预测IgA肾病预后中的作用， 通过用MIB-1对肾活检进行免疫染色来确定， 抗原在G1、S2、S和M期细胞中表达，而在G0期细胞中不表达。 由于TGF β是细胞外基质产生的主要介质， 这种瘢痕介质在肾活检材料中的沉积将是 通过免疫组织化学染色进行评估。 阐明胶原蛋白的作用 I和IV型胶原在进行性IgA 肾病，这些大分子的沉积也将通过 免疫组织化学染色。 从106例患者中获得诊断性肾活检 IgA肾病患者，最近完成的 临床试验，将用于确定进展风险因素， 对肾小球和间质增殖指数和相对 TGF β、胶原I和胶原IV的表达。 例iga 肾病和高进展风险因素将被输入一个 前瞻性研究，以评估不同量的omega（n）-3） 鱼油浓缩物中的高度不饱和脂肪酸 肾功能结局。

IgA nephropathy, the most common form of glomerulonephritis worldwide, is characterized by a variable clinical course with progression to chronic renal disease in 20-40% of patients. Dietary fish oil supplementation significantly retarded the rate of renal function in a group of proteinuric patients with IgA nephropathy in a recently completed clinical trial conducted by the Mayo Nephrology Collaborative Study Group. Currently, it is difficult to identify patients that would be most likely to benefit from such therapy, because there are few clinicopathologic parameters that provide prognostic information in an individual patient. Since endocapillary proliferation and extracellular matrix deposition are principal morphologic alterations in IgA nephropathy, we propose to determine whether new methods to assess these parameters may provide additional prognostic information and provide a basis for therapeutic decisions in newly diagnosed patients. The role of glomerular and interstitial proliferation in predicting outcome in IgA nephropathy will be determined by immunostaining renal biopsies with MIB-1, which identifies an antigen expressed in G1, S2, S, and M phase cells, but not in G0 cells. Since TGFbeta is a dominant mediator of extracellular matrix production, deposition of this cicatricial mediator in renal biopsy material will be assessed by immunohistochemical staining. To clarify the role of collagen I and collagen IV accumulation during the course of progressive IgA nephropathy, deposition of these macromolecules will also be assessed by immunohistochemical staining. Diagnostic renal biopsies obtained from 106 patients with IgA nephropathy, the study cohort of the recently completed clinical trial, will be used to establish progression risk factors based upon glomerular and interstitial proliferation indices and relative expression of TGFbeta, collagen I, and collagen IV. Patients with IgA nephropathy and high progression risk factors will be entered into a prospective study to assess the effects of varying amounts of omega (n)-3) highly unsaturated fatty acids administrated in fish oil concentrates on renal function outcome.