细菌及支原体的IgA1蛋白酶

有些致病菌能分泌ＩｇＡ１蛋白酶,此酶能特异地将ＩｇＡ１分子降解成完整的Ｆａｂ段与Ｆｅ段,尽科这同细菌的ＩｇＡ１蛋白酶在生化特性上各不相同,但在各自的栈分子障敢存在相同的抗原表位。细菌基因组间水平性遗传交换导致的ＩｇＡ１蛋白酶基因的特殊的镶嵌结构是产生该蛋白酶抗原性存在差异的遗传基础。本文对细菌ＩｇＡ１蛋白酶及其人基因特点和此酶在感染中可能作用方面的研究答一综述。     

孢素联合糖皮质激素对IgA肾病患者IgA、C3及IgA/C3影响研究

目的:探讨孢素联合糖皮质激素对IgA肾病患者IgA、C3及IgA/C3的影响。方法:我院收治的IgA肾病住院患者90例,按用药不同分为对照组与实验组。对照组予以醋酸泼尼松片口服,实验组在对照组基础上予以予环孢素软胶囊口服,治疗结束后对患者的血肌酐、血尿酸、24 h尿蛋白定量及IgA、C3、IgA/C3进行检测。结果:与对照组相比,实验组24 h尿蛋白定量水平较低,P0.05;IgA水平及IgA/C3水平较低,P0.05,差异具有统计学意义;两组患者的C3、血肌酐、血尿酸水平无显著差异,无统计学意义(P0.05)。结论:孢素联合糖皮质激素能够显著降低Ig A肾病患者Ig A水平及IgA/C3,对C3水平无影响,对临床有指导意义。     

IgA 肾病患者与膜性肾病患者外周血单核细胞mRNA分析

为了寻找诊断、鉴别IgA肾病(IgAN)和膜性肾病(MN)的血液特异性标记物,利用公共数据库中的IgAN和MN患者的外周血单核细胞(PBMCs)的转录组表达谱数据集识别特异性生物标记物,为诊断和鉴别提供简便、可靠的依据补充。从公共基因表达数据库(GEO)下载IgAN患者组(n=15)和MN患者组(n=8)芯片数据集,筛选前250个差异表达基因(DEGs)。通过分析筛选关键基因和途径,进行基因本体(GO)富集分析、京都基因与基因组百科全书(KEGG)通路分析和蛋白质与蛋白质相互作用关系(PPI)分析等进一步了解DEGs。通过分析共发现75个显著DEGs,其中73个上调基因,2个下调基因。GO富集分析的生物学过程(BP)主要包括蛋白质转运、内溶酶体到溶酶体转运、趋化因子介导的信号通路作用等。显著富集差异表达基因KEGG通路分析包括Endocytosis和Hepatitis B的相关信号通路。PPI筛选出EPS15、STAT4、CCL2、SUN2、SEC24C、SEC31A、GOLGB1、F2R,RAB12和PTK2B等关键基因。成功筛选出核心差异表达基因,为IgAN和MN的诊断和鉴别提供简便、可靠的依据补充,甚至提供治疗的新靶点。     

骨化三醇对IgA肾病患者血清无机盐离子、肾小管间质损伤尿液生物学标志物及肾小球功能的影响

目的:探讨骨化三醇对Ig A肾病患者血清无机盐离子、肾小管间质损伤尿液生物学标志物及肾小球功能的影响。方法:选取我院收治的70例Ig A肾病患者,根据数字随机分组的方式分为对照组(35例)和观察组(35例)。对照组给予厄贝沙坦片,观察组给予厄贝沙坦片和骨化三醇胶丸。比较两组治疗前后血钾(K)、血钙(Ca)、血磷(P)、α1微球蛋白(α1-MG)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)、尿β2微球蛋白(β2-MG)及尿微量白蛋白(U-m Alb)水平的变化。结果:治疗后,两组血K、Ca、P含量与治疗前相比差异均无统计学意义(P0.05),且组间比较差异亦不显著(P0.05);观察组肾小管间质损伤尿液生物学标志物(血清α1-MG、NAG)水平均较治疗前显著降低(P0.05),且均明显低于对照组(P0.05);两组肾小球功能相关因子(血清β2-MG、U-m Alb)水平较治疗前均显著降低(P0.05),且观察组以上指标均明显低于对照组(P0.05)。结论:厄贝沙坦联合骨化三醇治疗Ig A肾病能有效减少肾小管损伤,并改善肾小球功能。     

IgA肾病患者与健康人肠道菌群的比较

目的通过16S rRNA高通量基因测序方法对IgA肾病患者与健康人的肠道菌群进行比较。方法纳入生活于同一地区的40例IgA肾病患者与10例健康人,收集研究对象的新鲜粪便样本,提取粪便细菌总DNA,通过PCR扩增后上机测序,然后进行可操作分类单元聚类、物种分类分析及Alpha多样性分析、Beta多样性分析,最后比较两组之间的肠道菌群差异。结果与健康人相比,IgA肾病患者肠道菌群丰富度指数(Ace、Chao1)下降(u=2.308,P=0.033;u=2.259,P=0.039),多样性指数(Shannon、Simpson)升高(u=5.370,P0.001;u=4.601,P=0.007);相对丰度方面,IgA肾病患者的厚壁菌门、拟杆菌门、放线菌门细菌数量增加(t=2.301,P=0.037;t=6.729,P=0.005;t=5.285,P=0.006),而变形菌门细菌数量减少(t=4.138,P=0.009);拟杆菌属、链球菌属细菌数量增加(t=9.037,P=0.003;t=6.001,P=0.008),而unidentified_Enterobacteriaceae数量减少(t=2.198,P=0.033)。PCoA图提示两组肠道菌群有显著差异。LDA差异贡献分析发现两组之间共有15个物种存在显著差异,其中造成显著差异影响力最大的5个物种依次是γ-变形菌纲、unidentified_Enterobacteriaceae、肠杆菌科、肠杆菌目、变形菌门(t=9.930,P=0.002;t=2.198,P=0.033;t=2.604,P=0.015;t=2.393,P=0.021;t=4.138,P=0.009),它们刚好落在同一个进化树上,在IgA肾病组的相对丰度显著降低。结论 IgA肾病患者存在肠道菌群失调,显著减少的肠杆菌科的未知属可能是IgA肾病的特征菌,其对机体免疫的影响及在IgA肾病发生发展中的作用尚不清楚,进一步研究可能为IgA肾病的防治提供新的靶点。     

双倍剂量氯沙坦治疗IgA肾病中蛋白尿疗效评价

目的：探讨双倍剂量氯沙坦氯沙坦在IgA肾病（IgA nephropathy,teAN）中降低蛋白尿的临床疗效。方法：选取40例经肾穿刺病理诊断为IgAN的患者,随机分为2组,A组18例采用单剂量（50mg,qd）氯沙坦;B组22例用双倍剂量（100mg,qd）氯沙坦,观察8周后两组的血压、实验室指标：血肌酐、尿素氮、血钾、24h尿蛋白、内生肌酐清除率（creatinine clearancerate,CCr）等以及临床症状,并作安全性评价。结果：B组患者24h蛋白尿下降（0．91±0．33g／24h）,A组患者蛋白尿下降（0．21±0．22g／24h）,B组24h蛋白尿下降率明显高于A组（P〈0．05）。双倍剂量氯沙坦在IgAN治疗中未出现不良反应,包括高血钾、咳嗽、低血压或水肿等。结论：双倍剂量氯沙坦在治疗IgAN中降蛋白尿的疗效较单剂量明显,应用安全,耐受性好,无明显不良反应。     

IgA肾病与膜性肾病患者肠道微生物菌群结构分析

【背景】越来越多的证据表明肠道失衡与免疫介导的疾病相关,但肠道菌群和免疫介导的肾脏疾病之间的关系仍不清楚。【目的】通过Illumina高通量测序方法对IgA肾病(immunoglobulin A nephropathy, IgAN)、膜性肾病(membranous nephropathy, MN)患者和健康人群的肠道菌群进行比较。【方法】回顾性选择2020年9月–2021年12月期间,在甘肃省人民医院肾内科行肾穿刺活检并诊断为IgAN及MN患者的新鲜粪便标本,分别编号为IgAN组和MN组,收集体检中心健康人群粪便标本作为健康对照组,每组样本为10例。采用高通量测序技术对粪便样本中所有细菌的16S rRNA基因V3-V4区进行DNA测序,然后进行分类操作单元(operational taxonomic units, OTU)、物种分类、α多样性、β多样性等分析,比较3组之间的肠道菌群差异。【结果】与健康对照组相比,门水平上IgAN组的变形菌门(Proteobacteria)和放线菌门(Actinobacteria)比例明显增高,分别为18%vs. 4%和18.3%vs. 5%;属水平上I...     

IgA肾病预后的相关影响因素分析

目的：分析IgA肾病预后的相关影响因素,为[gA肾病的治疗提供可靠的依据。方法：选择我市三家医院经病理确诊的143例IgA肾病患者,记录其临床资料,根据随访结果将患者的预后分为优、良、中、差4个档次,通过单因素、多因素等方法获得IgA肾病预后的影响因素。结果：1．LEE氏病理组织学分级是[gA肾病患者预后的危险因素,分级越高预后越差,P〈0．01。2．单因素分析：年龄、病程、高血压、尿蛋白含量、水肿程度、肉眼血尿均为其危险因素,ACEI治疗为其保护因素,P〈0．01。3．多因素分析显示尿蛋白含量、LEE肾组织学分级、病程、高血压及ACEI治疗纳入的累计概率模型有统计学意义。结论：尿蛋白含量、LEE肾组织学分级、病程、高血压是IgA肾病预后的危险因素,ACEI治疗是其保护因素。     

寨卡病毒感染者血液、尿液和唾液中IgA抗体水平初步研究

为研究寨卡病毒(ZIKV)感染者血清、尿液和唾液样本中特异性IgA抗体水平,进一步了解ZIKV感染免疫机制,本研究重组表达制备寨卡病毒NS1蛋白,对其浓度、纯度进行鉴定,初步评估了NS1蛋白抗原性,并建立间接酶联免疫(Indirect-ELISA)方法,检测患者临床血清、尿液和唾液样本中的寨卡特异性IgA抗体。利用健康人群血清、尿液和唾液标本,评估检测方法的特异性,并确定以阴性对照的均值加3倍标准差作为判定检测结果的阈值,特异性为100%。对经病毒核酸检测所确诊病例的33份血清样本、4份尿液样本和3份唾液样本进行检测。选择3份具有较高IgA抗体水平的血清,通过2倍系列稀释的方法评价了血清样本中特异性IgA抗体的滴度,可有效检出经3 200倍以上稀释的血清样本中的IgA抗体。重复性检测实验显示板间变异系数为(3.0±0.8)%,板内变异系数为(2.7±1.0)%。寨卡患者血清、尿液和唾液样本中的特异性IgA抗体的检出率分别为75.8%(25/33)、100%(4/4)和33.3%(1/3),提示IgA抗体在3种体液标本中均具有显著的存在,具有充当体外诊断指标的意义。同时尿液、唾液标本中特异性IgA抗体的存在,提示潜在的粘膜免疫效应,有助于增强对病毒体内播散和体外传播的理解,也初步提示了寨卡病毒NS1蛋白可用于相关免疫学诊断试剂的研发。     

血管内皮细胞生长因子及其受体在IgA肾病患者肾组织中表达的研究

目的　检测 2 4例不同病理改变的IgA肾病患者肾组织中血管内皮细胞生长因子 (Vascularendothelialgrowthfactor,VEGF)及其受体VEGF R2 (flk 1)和Ⅳ型胶原的表达 ,并将其表达水平与临床病理改变进行相关分析。方法　应用免疫组织化学SP法。结果　VEGF主要表达于肾小球脏层上皮细胞 ,flk 1主要表达于肾小球和间质血管内皮细胞。肾小球内VEGF和flk 1表达呈正相关 (P <0 0 5 ) ,两者在中度病变组肾小球内表达最多 ,重度病变组表达最少 (P <0 0 5 )。随病理改变程度加重 ,患者 2 4h尿蛋白定量、血压、血肌酐水平均明显增高 (P <0 0 5 )。肾小球内VEGF表达在轻、中度病变组与尿蛋白水平呈正相关 (P <0 0 5 ) ;在重度病变组则无相关性 ,与患者血压、血肌酐水平也无明显相关性 (P >0 0 5 )。肾小球内Ⅳ型胶原随病变加重表达增多 ,在重度病变组表达最多 (P <0 0 1) ;在轻、中度病变组肾小球内VEGF表达与Ⅳ型胶原的表达呈正相关 (P <0 0 5 )。各组肾小球内VEGF表达与肾小球微血管密度呈正相关 (P <0 0 1) ,重度病变组肾小球微血管密度减少 (P <0 0 5 )。结论　这些结果说明VEGF在IgA肾病的病理进展过程中发挥重要作用 ,可能涉及内皮细胞通透性增强、细胞外基质合成增多、血管生成障碍等多种机制     

Aberrant glycosylation of IgA from patients with IgA nephropathy

Despite the prominent role of IgA, particularly IgA₁, in the pathogenesis of IgA nephropathy (IgAN), the precise role of this molecule in the process remains unclear. Four biotin-conjugated lectins in sandwich-type enzyme-linked immunosorbent assays were devised to determine the glycosylation profiles of total IgA and its subclasses. We took advantage of differential binding properties of these lectins to sugar residues to dissect the oligosaccharide chainsO-linked to the hinge and thoseN-linked to the Fc region of total IgA and IgA subclasses in 47 patients with IgAN and an equal number of controls. The proportion of sialylated IgA₁ was higher in patients compared with controls (p<0.02), whereas IgA₂ in patients appeared less well sialylated. A reduction of galactose in pathological IgA as detected by RCA-I became significant after treatment of the molecule with neuraminidase (p<0.01). Defective galactosylation was also observed for patient IgA₁ when it was probed with ECL, a lectin that has a specificity for Gal 1,4N-acetylglucosamine groupings onN-linked oligosaccharides. The RCA and ECL results, therefore, suggest that increased sialylation on the IgA₁ is onO-linked oligosaccharides in the hinge region. This was partly confirmed by a small increase in the binding of PNA to IgA₁ from the patient group. This lectin binds preferentially to Gal 1,3N-acetylgalactosamine groups that are found onO-linked oligosaccharides.     

Characterization of a major Mycoplasma penetrans lipoprotein and of its gene

Abstract A novel mycoplasmal species designated as Mycoplasma penetrans has been isolated recently from patients infected with human immunodeficiency virus. p35, a major antigen extracted from the membrane of this mycoplasma using Triton X-114 has been found to be a lipoprotein. After proteolytic treatment of p35, the sequence of one of the resulting peptides was determined and a corresponding oligonucleotide was deduced. Using this oligonucleotide as a probe the p35 gene was cloned and sequenced. Sequence analysis revealed an amino-terminal signal peptide with a potential acylation site which would result in a 35.3 kDa mature product. In addition, the p35 gene was followed by an open reading frame with a corresponding polypeptide partially homologous to p35, in particular to the N-terminus region.     

Mycoplasma penetrans infections and seroconversion in patients with AIDS: identification of major mycoplasmal antigens targeted by host antibody response

We examined Mycoplasma penetrans-specific antibodies in sera of five male homosexual AIDS patients from whom M. penetrans was isolated during the disease process. No consistent immune reaction pattern could be recognized in Western blot using whole cell proteins. Serum samples obtained prior to M. penetrans isolation reacted with a number of M. penetrans proteins, most likely due to non-specific cross-reactions. Further analysis revealed that patients produced prominent antibody reaction to lipid-associated membrane proteins (LAMPs) of M. penetrans at the time of mycoplasma isolation, which could not be observed for serum samples obtained prior to M. penetrans isolation. The positive antibody reaction was mainly directed against two major LAMPs of M. penetrans with molecular mass of 35 and 38 kDa and produced a distinctive pattern of positive immunoreaction bands. Our observation suggested that, comparing with whole mycoplasmal proteins, LAMPs were more specific target antigens in serological assays for M. penetrans infection.     

Comprehensive metabolomic profiling in early IgA nephropathy patients reveals urine glycine as a prognostic biomarker

Identification of a urinary metabolite biomarker with diagnostic or prognostic significance for early immunoglobulin A nephropathy (IgAN) is needed. We performed nuclear magnetic resonance-based metabolomic profiling and identified 26 metabolites in urine samples. We collected urine samples from 201, 77, 47, 36 and 136 patients with IgAN, patients with membranous nephropathy, patients with minimal change disease, patients with lupus nephritis and healthy controls, respectively. We determined whether a metabolite level is associated with the prognosis of IgAN through Cox regression and continuous net reclassification improvement (cNRI). Finally, in vitro experiments with human kidney tubular epithelial cells (hTECs) were performed for experimental validation. As the results, the urinary glycine level was higher in the IgAN group than the control groups. A higher urinary glycine level was associated with lower risk of eGFR 30% decline in IgAN patients. The addition of glycine to a predictive model including clinicopathologic information significantly improved the predictive power for the prognosis of IgAN [cNRI 0.72 (0.28-0.82)]. In hTECs, the addition of glycine ameliorated inflammatory signals induced by tumour necrosis factor-α. Our study demonstrates that urinary glycine may have diagnostic and prognostic value for IgAN and indicates that urinary glycine is a protective biomarker for IgAN.     

Difference in IgA1 O-glycosylation between IgA deposition donors and IgA nephropathy recipients

IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis, and disease recurrence often occurs after transplantation. On the other hands, Asymptomatic IgA deposition (IgAD) is occasionally observed in donated kidney. It is recognized that IgAD does not progress to IgAN, but the mechanism has not demonstrated yet. In IgAN, aberrant IgA1 O-glycan structure in the hinge region (HR) of serum IgA is suggested as one of the most convincing key mediators. However, little is known about IgA1 O-glycan structure in IgAD patients. Herein, we investigated the prevalence of IgAD in living renal transplant donors in our cohort. IgAD was observed in 21(13.0%) among 161 renal transplant donors and have statistically significant blood relationship with IgAN recipients (28.6% in relatives vs. 9.8% in non-relatives, respectively; p?=?0.0073). Next, we evaluated the IgA1 O-glycan structure of serum IgA from IgAN recipients (n?=?26), IgAD donors (n?=?17), and non-IgAD helthy donors (n?=?27) using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI–TOF MS). The numbers of GalNAc and Gal and the Gal/GalNAc ratio in the HR of the IgAN recipients had significantly lower comparing to the IgAD and non-IgAD healthy donors. The decreased Gal/GalNAc ratio in IgAN recipients means the increased ratio of galactose-deficient IgA1. To the best of our knowledge, this is the first report to compare the O-glycan structures in IgAN recipients and IgAD donors using MALDI–TOF MS. We concluded that IgAD was more common in IgAN related donors. Overall, decreased GalNAc and Gal contents in HR could play a material pathogenic role in IgAN.     

Proteomic analysis of urinary exosomes from patients of early IgA nephropathy and thin basement membrane nephropathy

To identify biomarker candidates associated with early IgA nephropathy (IgAN) and thin basement membrane nephropathy (TBMN), the most common causes presenting isolated hematuria in childhood, a proteomic approach of urinary exosomes from early IgAN and TBMN patients was introduced. The proteomic results from the patients were compared with a normal group to understand the pathophysiological processes associated with these diseases at the protein level. The urinary exosomes, which reflect pathophysiological processes, collected from three groups of young adults (early IgAN, TBMN, and normal) were trypsin-digested using a gel-assisted protocol, and quantified by label-free LC-MS/MS, using an MS(E) mode. A total of 1877 urinary exosome proteins, including cytoplasmic, membrane, and vesicle trafficking proteins, were identified. Among the differentially expressed proteins, four proteins (aminopeptidase N, vasorin precursor, α-1-antitrypsin, and ceruloplasmin) were selected as biomarker candidates to differentiate early IgAN from TBMN. We confirmed the protein levels of the four biomarker candidates by semi-quantitative immunoblot analysis in urinary exosomes independently prepared from other patients, including older adult groups. Further clinical studies are needed to investigate the diagnostic and prognostic value of these urinary markers for early IgAN and TBMN. Taken together, this study showed the possibility of identifying biomarker candidates for human urinary diseases using urinary exosomes and might help to understand the pathophysiology of early IgAN and TBMN at the protein level.     

Enhanced intrarenal oxidative stress and angiotensinogen in IgA nephropathy patients

This study was performed to determine whether immunoreactivity of intrarenal hemeoxygenase-1 and angiotensinogen are increased in IgA nephropathy (IgAN) patients. Hemeoxygenase-1 and angiotensinogen immunoreactivity were determined by immunohistochemistry robot system in renal specimens from 39 patients with IgAN. Normal portions of surgically resected kidney served as controls. IgAN patients showed moderate proteinuria (1.1+/-0.2 g/day); however, the control group did not show any proteinuria. Immunoreactivity of intrarenal hemeoxygenase-1 and angiotensinogen in IgAN were significantly increased compared to normal kidneys (2.42+/-0.42 vs 1.00+/-0.26 for hemeoxygenase-1 and 4.05+/-0.40 vs 1.00+/-0.21 for angiotensinogen, arbitrary unit). Even though these IgAN patients did not show massive renal damage, hemeoxygenase-1 and angiotensinogen immunoreactivity were increased in these patients at this time point. These data suggest that activated intrarenal reactive oxygen species-angiotensinogen axis plays some roles in development of IgAN at the early stage and will provide supportive foundation of effectiveness of the renin-angiotensin system blockade in IgAN.     

Invasion of HeLa cells by Mycoplasma penetrans and the induction of tyrosine phosphorylation of a 145-kDa host cell protein

Abstract The ability of Mycoplasma penetrans to invade eukaryotic cells was studied using a HeLa cell line. The bactericidal antibiotic, gentamicin, in combination with low concentrations of Triton X-100, was utilized to kill mycoplasmas that had not entered the cells, allowing the quantitation of internalized organisms. The intracellular location of the mycoplasma was also documented by transmission electron microscopy. The actin polymerization inhibitor cytochalasin-D markedly inhibited the internalization process, whereas the tyrosine phosphorylation inhibitors, staurosporin and genistein had only a slight effect. As against the invasion of enteropathogenic Escherichia coli which depends on tyrosine phosphorylation of a 90-kDa (Hp90) HeLa cell protein, internalization of M. penetrans by HeLa cells was independent of the phosphorylation of Hp90. Nonetheless, tyrosine phosphorylation of a 145-kDa HeLa cell protein was found to be associated with the interaction of M. penetrans with HeLa cells.