Korean Journal of Nephrology 2001;20(4):556-564.

논평 : IgA 신병증 환자에서 신장조직내 TGF - β , IL-6 Osteopontin 및 MCP-1 유전자 발현에 관한 연구 (Editorial : MCP-1 , TGF-β, IL-6 , and Osteopontin Gene Expression in IgA Nephropathy)

이강욱(Kang Wook Lee),송정헌(Jung Hun Song),박기현(Ki Hyun Park),이상주(Sang Joo Lee),장윤경(Youn Kyung Chang),양종오(Jong Oh Yang),나기량(Ki Ryang Na),서광선(Kwang Sun Suh),신영태(Young Tai Shin)

Abstract

In many experimental models and human renal diseases, TGF- 0, IL-6, osteopontin and MCP-1 have been thought to be involved in progressive re- nal injury mechanism. In order to evaluate the renal expression of these genes in six control patients (Group A) whose renal biopsy had shown only minimal lesion and no immune deposition on the light and immunofluorescent microscopic examinations and sixteen patients(Group B) who had been confirmed with primary IgA nephropathy by renal biopsy frorn Jan. 1999 to Jan. 2000 in Chungnam National University Hospital were included in this study. Competitive RT-PCR was performed to estimate the each gene studied and GAPDH expression levels of kidney biopsy specimens. The magnitude of each gene expression was represented as the ratio to GAPDH. Twenty-four hour urinary protein excretion of Group B(mean 3,882 mg/day) was significantly higher than that of Group A(mean 560 mg/day, p<0.01). The TGF- β, MCP-1, and IL-6 gene expressions of Group B(0.88±0.21, 0.85±0.14, 1.59±0.24, and 1.50±0.24, respectively) were significantly higher than those of Group B(0.19±0.14, 0.18±0.03, and 0.57±0.18, respectively, p<0.05, p<0.05, p<0.05, p<0.05). The MCP-1, osteopontin and IL-6 gene expressions of 6 IgA nephropathy patients with crescents in glomeruli and marked tubulointerstitial mononuclear cell infiltration on light microscopic examination(1.40>0.32, 2.07±0.40, 1.85>0.31, respectively) were significantly higher than those of 10 IgA nephropathy patients without crescents or marked tubulointerstitial mononuclear cell infiltration(0.59±0.24, 0.74±0.18, 1.050.18, respectively, p<0.05, p<0.05, p<0.05). The level of MCP-1 gene expression was significantly positively correlated with the magnitude of 24 hour protein excretion(r2=0.54, p<0.05). However, the level of TGF-0, osteopontin and IL-6 gene expressions were not significantly correlated with the magnitude of proteinuria. With the above results, we speculate that upregulation of osteopontin, MCP-1, IL-6 genes of the kidney may be related to rapid progressive renal in- jury process in patients with IgA nephropathy.