| Objective:Wnt/β-catenin is an evolutionarily conserved signaling pathway that regulates organ development,tissue homeostasis,and the pathogenesis of human disease.Deregulation of Wnt4/β-catenin expression leads to various developmental disorders and diseases,such as congenital abnormalities of the kidney and urinary tract,cystic kidney and kidney cancer.To investigate the relationship between Wnt4 and β-catenin and renal tubular damage and renal interstitial fibrosis by observing the expression of Wnt4 and β-catenin in renal tissues of primary glomerulonephritis,and further explore Wnt4/β-catenin signal transduction.Pathway may play a role in the process of primary glomerulonephritis promoting renal fibrosis.Methods:A total of 56 patients with primary glomerulonephritis and renal biopsy were enrolled in the study.The paraffin sections of renal histopathological specimens were stained with PAS.Morphological changes of renal tissues were observed under light microscope.According to the tubulointerstitial injury score.The patients were divided into three groups: 22 patients with mild renal tubular injury,18 patients with moderate renal tubular injury,and 16 patients with severe renal tubular injury.There was no significant difference in age and gender between the groups.Normal kidney tissue(both from the distal end of the kidney tumor(3-5 cm)normal kidney tissue was used as a control group.immunohistochemistry was used to detect the expression levels of Wnt4 and β-catenin in renal tissues,and the differences between the groups were compared;The patients enrolled in the day of renal wear were given fasting peripheral blood,middle morning urine specimens,biochemical detection of urine β2 microglobulin,serum creatinine and other clinical indicators,EPI calculation of glomerular filtration rate.Correlation analysis: Wnt4/β-catenin levels The relationship between changes and renal tubular damage and renal interstitial fibrosis.Results:1.Clinical data of the study subjects,including 29 males and 27 females,aged 18-69 years,with an average age of 42.64±12.72 years;clinical data of 10 normal normal control groups were collected,including 8 males and females.2 cases,aged between 29 and 66 years,with an average age of 47.40 ± 10.88 years.There was no significant difference in age and gender between the primary glomerulonephritis group and the normal control group.2.Renal tubular injury score: The renal tissue was observed under light microscope.The results showed that there was no significant change in the renal tubule of the control group.Compared with the control group,the renal tissue of primary glomerulonephritis showed different degrees of renal tubule and kidney.For fibrosis,the pathological scores of the lesions were 2.55±0.74 in the mild renal tubular injury group,4.39±0.50 in the moderate renal tubular injury group,and 7.50±9.97 in the severe renal tubular injury group.The difference between the groups was statistically significant.Significance(P<0.05);3.Analysis of clinical indicators: The expression levels of β2 microglobulin in each group were: normal control group: 0.108±0.05,mild renal tubular injury group was 0.58±0.33,moderate renal tubular injury The group was 1.08±0.65,and the severe renal tubular injury group was 0.76±0.43.The urinary β2 microglobulin excretion in the primary glomerulonephritis group was higher than that in the normal control group,and was positively correlated with the degree of renal tubular injury.The difference was statistically significant.(P<0.05);the expression levels of e GFR in each observation group were: normal control group: 101.04±12.09,mild renal tubular injury group was 90.34±54.42,moderate renal tubular injury group was 78.51±41.47,severe renal tubule The injury group is 45.34±31.80,and the e GFR is in the light.There was no statistical difference between the degree group and the normal control group,and the expression in the severe group was decreased,and the difference was statistically significant(P<0.05).The results of immunohistochemistry showed that Wnt4 and β-catenin were only weakly expressed in the renal tissues of normal control group,mainly found in some renal tubular epithelial cells and mesangial cells;compared with normal control group,primary kidney The strong expression of Wnt4 and β-catenin was observed in the renal tissue of glomerulonephritis.The expression sites of the two were consistent,and the expression region was mainly located in the tubulointerstitial fibrosis.The expression of Wnt4 in the renal tissue of the primary glomerulonephritis group was 3.77±1.23 in the mild renal tubular injury group,5.06±1.39 in the moderate renal tubular injury group,and 6.06±1.18 in the severe renal tubular injury group.The difference between the groups was statistically significant(P<0.05).The expression of β-catenin in the renal tissue of the primary glomerulonephritis group was 3.86±1.46 in mild renal tubular injury group,moderate renal tubular injury.The group was 5.06±1.39,and the severity of renal tubular injury was 6.38±1.82.The difference between the groups was statistically significant(P<0.05).4.Correlation analysis showed that the positive expression level of Wnt4 in renal tubular epithelial cells and β-There was a significant positive correlation between catenin(r=0.96,P<0.05).The renal tubular injury score was significantly positive with Wnt4 expression intensity(r=0.75,P<0.01)and β--catenin(r=0.71,P<0.01).Correlation,suggesting that the expression intensity of Wnt4 and β-catenin gradually increases with the severity of tubulointerstitial fibrosis.5.Correlation between Wnt4 and clinical indicators: The expression intensity of Wnt4 in renal tubular epithelial cells was positively correlated with urinary β2 microglobulin(r=0.34,P<0.05),and e GFR(r=-0.38,P< 0.05)showed a negative correlation;the correlation between β-catenin and clinical indicators: the expression intensity of β-catenin in renal tubular epithelial cells was positively correlated with urinary β2 microglobulin(r=0.30,P<0.05).e GFR(r=-0.31,P<0.05)showed a negative correlation.Conclusion: 1.The expression of Wnt4 and β-catenin in renal tissue of primary glomerulonephritis is enhanced with the aggravation of renal tubular and renal interstitial injury.2.High expression of Wnt4/β-catenin signaling pathway may be renal tubular injury.One of the important mechanisms of interstitial fibrosis is involved in the progression of end-stage renal disease. |
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