OMEGA 3 FATTY ACIDS IN IGA NEPHROPATHY

IgA肾病是世界上最常见的肾小球肾炎形式， 以进展为慢性疾病的不同临床病程为特征的 肾脏疾病的患者占20-40%。日粮鱼油补充剂 显著延缓一组蛋白尿症患者的肾功能 最近完成的一项临床试验中的IgA肾病患者 由梅奥肾脏学合作研究小组进行。目前，它 很难确定哪些患者最有可能从中受益 这种疗法，因为很少有临床病理参数 提供个别患者的预后信息。自.以来 毛细血管内增殖和细胞外基质沉积 IgA肾病的主要形态改变，我们建议 确定评估这些参数的新方法是否可以提供 其他预后信息，并为治疗提供基础 在新诊断的患者中做出决定。肾小球和肾小球的作用 间质增殖在预测IgA肾病预后中的作用 通过MIB-1免疫染色肾活检确定，它识别一个 抗原在G1、S2、S和M期细胞中表达，而在G0细胞中不表达。 由于转化生长因子β是细胞外基质产生的主要介质， 在肾活检材料中沉积这种瘢痕介质将是 通过免疫组织化学染色进行评估。阐明胶原蛋白的作用 进行性IgA病程中I型和IV型胶原的蓄积 肾病，这些大分子的沉积也将通过 免疫组织化学染色。106份诊断性肾活检 最近完成的研究队列中的IgA肾病患者 临床试验，将用于确定进展风险因素的基础 肾小球和间质增殖指数及相关指标的研究 IgA患者血清中转化生长因子β、I型和IV型胶原的表达 肾病和高进展风险因素将被纳入 评估不同剂量omega(N)-3影响的前瞻性研究) 鱼油中的高度不饱和脂肪酸浓缩在 肾功能转归。

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.