【摘要】 目的通过对伴IgA沉积的微小病变肾病综合征(MCNS-IgA)患者血清中IgA1分子糖基化缺陷程度的检测,探讨MCNS-IgA的可能的病理分类归属。方法选择北京大学人民医院肾内科MCNS-IgA患者10例,微小病变肾病综合症(MCNS)患者10例、大量蛋白尿IgAN(H-IgAN)患者10例为对照。用双抗体夹心ELISA法检测各组患者血清IgA1的相对浓度,用黑木凝集素检测IgA1分子的α2,6唾液酸水平,花生凝集素检测IgA1分子的半乳糖水平,蜗牛凝集素检测IgA1分子的N-乙酰氨基半乳糖水平,计算经血清IgA1浓度校正的各糖基水平。观察MCNS-IgA组患者血清IgA1分子糖基化缺陷情况,并且与H-IgAN及MCNS组进行比较。结果 与MCNS组相比,MCNS-IgA肾病患者血清IgA1的α2,6唾液酸(1.232±0.250比较1.379±0.623,P=0.455)、半乳糖缺失(0.204±0.053vs0.229±0.088,P=0.454)水平及N-乙酰氨基半乳糖暴露(0.191±0.039vs0.205±0.068,P=0.626)水平无明显差异。但其血清IgA1分子α2,6唾液酸缺失(1.232±0.250vs0.756±0.243,P=0.015)及N-乙酰氨基半乳糖的暴露(0.191±0.039比0.258±0.066,P=0.025)显著低于H-IgAN组,半乳糖缺失少,但未达统计学差异(0.204±0.053比0.139±0.038,P=0.052)。结论 MCNS-IgA组患者血清IgA1糖基化水平上显示了与IgA肾病不同的特点,提示其可能是微小病变伴IgA分子的非特异性沉积。更多还原

【Abstract】 Objective To test the different degree of glycosylation of serum IgA1 among MCNSIgA,H-IgAN,MCNS,in order to investigate the relationship between MCNS-IgA and IgAN.Methods Sera from 30 patients were collected.10 of them were MCNS-IgA,10 patients were H-IgA and the rest were MCNS used as controls.Biotinylated lectins were used in ELISA to examine different glycans on serum IgA1 molecules.The a 2,6 sialic acid was detected by elderberry bark lectin(SNA),the exposure of terminal galactose(Gal) and N-acetylgalactosamine(GalNAc) were detected by arachis hypogaea(PNA) and Helix asperas agglutinin(HAA),respectively.The IgA1 glycans levels,corrected by IgA1 concentrations,were compared between patients and controls.Results Reduced terminal a 2,6 sialic acid(1.232 ± 0.250 vs 0.756 ± 0.243,P=0.015),and increased exposure of N-acetylgalactosamine(0.191 ± 0.039 vs 0.258 ± 0.066,P=0.025) were demonstrated in serum IgA1 from patients with H-IgAN as compared in that from MCNS-IgA.However,MNCS and MCNS-IgA had no significant differences among the levels of glycosylation(P > 0.05).Conclusion MCNS-IgA shows the characteristics of IgA nephropathy in serum IgA1 glycosylation level,suggesting the presence of MCD with non-specific mesangial IgA molecule deposition.更多还原