Expression And Clinical Significance Of The Inflammation-Related Factors TLR4 And NF-κB In The Renal Tissue Of Idiopathic Membranous Nephropathy

Objective: To study the inflammation related factor Toll-like receptor 4(TLR4),nuclear factor-kappa B(NF-κB)in idiopathic membranous nephropathy(IMN)expression levels in the renal tissue of the patients,And to explore the correlation between inflammatory factors and clinical biochemical indexes and 24 h urinary protein quantification in renal tissue cells of IMN patients,Understand the clinical significance of inflammation in the pathogenesis of IMN.Methods: In this study,45 patients who were initially diagnosed as IMN by renal biopsy in the Department of Nephrology of the First Affiliated Hospital of Bengbu Medical College from March 2021 to March 2022 were in the idiopathic membranous nephropathy group(IMN group),20 healthy kidney tissues retained by kidney resection for renal contusion,renal tumor or ureter tumor were selected as the normal control group(NC group).General clinical data and biochemical indicators were collected from the two groups and compared with the differences between the two groups.The expression of inflammatory cytokines TLR4 and NF-κB in renal tissue cells of IMN and NC groups was examined by IHC,and the mean optical density values were analyzed to compare the differences in the expression of inflammatory cytokines between the two groups.The IMN group was divided into 29 patients in fibrosis group and 16 patients in no fibrosis group,and the differences in expression between the two groups.The pearson correlation was applied to analyze the correlation between the two groups of inflammatory factors and with clinical indicators.Results: 1.Compared with NC group,24 h urinary protein quantification,total cholesterol,low density lipoprotein,high density lipoprotein,and serum triglyceride levels significantly increased in IMN(P<0.01,P<0.05),and serum albumin(P<0.01);serum creatinine,usea nitrogen,and uric acid were insignificant(P>0.05).2.Patients showed significantly higher expression levels of TLR4 and NF-κB in the IMN group than in the NC group(P<0.01).The expression of TLR4 and NF-κB was significantly stronger in the IMN fibrosis group than in the IMN no fibrosis group(P<0.05).3.Results of correlation analysis: TLR4 and NF-κB were closely related(P<0.01).Negative correlation of TLR4 with serum albumin and high density lipoprotein(P<0.01)and positively associated with 24 h urine protein quantification,serum cholesterol and low density lipoprotein(P<0.05,P<0.01).The NF-κB was correlated negatively with serum albumin and high density lipoprotein(P<0.05)and positively with urinary protein quantification at 24h(P<0.05).Conclusion: 1.The expression level of inflammatory factors TLR4 and NF-κB was significantly upregulated in IMN patients,causing cell damage in renal tissue,which may participate in the occurrence and development of IMN.2.The expression of inflammatory pathways in renal tissue cells of IMN patientsmay be involved in the progression of interstitial fibrosis in renal tissue.3.Proteinuria and blood lipids are closely related to the inflammatory response in IMN patients.