The Study On The Interconnection Between The Gene Polymorphisms And The Sensitivity Of Glucocorticoid And The Syndrome Type Of TCM In PNS

Objective Study the connection of between Candidate Gene Polymorphisms with Sensitivity of Glucocorticoid, Discuss the relation between Gene type and different TCM (Traditional Chinese Medicine) Syndromes, Research the relationship between pathology types and TCM syndromes in adult patients with Primary Nephrotic Syndrome(PNS).Methods 200 patients with Primary Nephrotic Syndrome, including 87 patients with sensitivity of glucocorticoid In order to test gene mutation points, analysis gene polymorphisms(GR,ABCB1,PAI-1,NPHS1 and NPHS2). And study the link between Gene Polymorphisms and sensitivity of glucocorticoid, Gene Polymorphisms and pathology types, Gene Polymorphisms and TCM syndromes were studied respectively, and the relationship among above multi-factors were analyzed by Multiple logistic regression method at the last step.Results①There were no Gene Polymorphisms in NPHS2-5 (686G/A,695C/T) gene and GR (ER22/23EK) gene.②In ABCB1-21,56.3% patients in sensitivity of glucocorticoid group(group 1) showed the symptom of Gene Polymorphisms changes, 65.5% in non-sensitivity of glucocorticoid group(group 2) showed the changes(P=0.339);In ABCB1-26,56.3% patients of group 1 showed the symptom of Gene Polymorphisms changes,55.8% of group 2 showed the changes(P=0.393).③In NPHS1-3,69% patients of group 1 showed the symptom of Gene Polymorphisms changes,79.6% of group 2 showed the changes; the occurrence frequency of homozygous mutation gene AA in group 2 was higher(P=0.019);the occurrence frequency of gene AA in membranous nephropathy patients was higher(P= 0.039);In Minimal changes disease PNS, the occurrence frequency of gene AA in group 2 was higher than group 1 (P=0.006).④In PAI-1 gene group,48.3% of group 1 showed the symptom of Gene Polymorphisms changes,50.4% of group 2 showed the changes; Comparing with healthy group, the occurrence frequency of type 4G/4G and type 4G/5G in PAI-1 gene was higher in PNS (Primary Nephrotic Syndrome) group (P=0.000);the gene type structures in sensitivity of glucocorticoid or non-sensitivity of glucocorticoid group had no obviously difference.⑤there was no link between kinds of genes Polymorphisms and TCM syndromes.Aanalyzed by Multiple logistic regression equation:①Considering each Gene Mutation as dependent variable, the results showed that Gene Mutation of NPHS1-3 (G349A) has a positive correlation with membranous nephropathy (P=0.021).②Considering each pathology types as dependent variable, and kinds of Gene Mutation and TCM syndromes as independent variable, some analysis showed the same results that IgA NS has a positive correlation with yin-deficiency syndrome (P=0.000) (P=0.029), and membranous nephropathy has a positive correlation with wind-dampness syndrome (P=0.033) (P=0.047).③Considering the degree of glucocorticoid sensitivity as dependent variable, the results showed that glucocorticoid sensitivity has a positive relationship with the patients'age (P=0.003),and also has a positive correlation with FSGS(P=0.031) and MN(P=0.024) in pathology types, while has a negative relationship wind-dampness syndrome (P=0.041) and yang-deficiency syndrome(P=0.005) in TCM syndromes.Conclusion①4G/4G,4G/5G type of PAI-1 gene have a high occurrence in patients with PNS.②Comparing with sensitivity of glucocorticoid group, type AA Homozygous Mutation of NPHS1 has a high occurrence in non-sensitivity of glucocorticoid group, which has some connections with the occurrence of membranous NS and non-sensitivity of glucocorticoid in minimal change NS patients.③There are no obviously connection between Candidate Gene and syndrome type of TCM.④he patients with sensitivity of glucocorticoid are wind-dampness syndrome and yang-deficiency syndrome, yin- deficiency syndrome are on the contrary.