Research Of Fas In The Peripheral Blood Of Patients With IgA Nephropathy

Objectives: Proliferation and apoptosis are a pair of balance mechanism that keep stablization of total number of cells. Cell apoptosis play an important role of pathogenesis, development, and regression of renal desease. Fas/FasL system is one of primary regulation factor. The conjuction of Fas ligand (FasL) and Fas receptor can induce cell apoptosis. Expression of Fas and FasL on lymphocyte regulate the lymphocyte apoptosis. Serum levels of soluble Fas (sFas) inhibit apoptosis of Fas positive cell by blocking conjuction of FasL and Fas. Serum sFas is apprently abnomal in autoimmunity desease. IgA nephropathy (IgAN) is a kind of glomerulemephritis which has a high desease incidence all over the world. Immunity and cytokines paticipate in the pathogenesis of IgAN. We investigated Fas expression on the lymphocyte and mesureed serum level of sFas in patients with IgAN and normal controls. On the base of clinical and pathologic data, we found relation of Fas in peripheral blood and clinical and pathologic index, aiming to supply a theory basement for the judgment nanagement, and prognosis prediction of renal injury.Methods: The normal controls (n=15) came from the healthy blood doners. The cases (n=55) were patients with IgAN that proved by renal biopsy, including mesangial and membrance proliferativeIgAN, endocapillary proliferadve IgAN, focal necrotic IgAN, focal sclerosing IgAN, focal proliferative IgAN, proliferative sclerosing IgAN and sclerosing IgAN. According to normality (SO Ccr 120ml/min)or not(Ccr 80ml/min) of the clearance of the creatinine (Ccr), the cases were divided into normal renal function (n=29)and abnormal renal function groups(n=26). Flowcytometry was used to examine the expression of Fas on lymphocyte of controls and cases.the serum levels of sFas was measured by sandwich ELISA. Serum creatink^ 24-hour urine protein excretion were assayed routinely in our labrotary.The blood pressure were measured by nurses , prior to administrated depressure drugs.The average arterial pressure were calculated by formulation (SBP+2DBP)/3.Ccr were calculated by formulation male:[(140-age) Xbody weight]/(72X Scr) female: [(140-age) X body weight]/(85 X Scr).Renal pathologic section were stained routinely with HE PAS PAS1VL Masson. The pathologic results were divided into five grades according to WHO standard.The outputs of the data were showed with means ?standard deviation,Comparation of variable were processed with analysis of variance and rank sum testThe correlation between two variables applied liner correlation analysis.Results: 1 The expression of Fas on lymphocyte in peripheral blood of controls and patients including normal and abnomal renal function were 19.18+4.40% 26.97+ 11.03%, 40.98+16.23% respectly.The difference was of statistic importance (p<0.05).it indicate that the expression of Fas on lymphocyte was up-regulated in IgAN which may be related with activation of lymphocyte. Serumlevels of sFas of three groups were 0.17+0.13ng/ml 1.46 + 0.71ng/ml 2.71+0.80ng/ml respectly. the difference was also obvious (p<0.05). 2 The expression of Fas on lymphocyte in peripheral blood had a negative correlation with Ccr (r= 0.448,p<0.01) ,but haven't correlation with the average arterial pressure and 24-hour urine protein excretion. The serum levels of sFas has a negative correlation with Ccr (r=0.558) and a positive correlation with the average arterial pressure (r=0.378) ,but haven't relation with 24-hour urine protein excretion. The results showed that serum levels of sFas was elevated accompaning the exacerbation of patients'condition. 3 The correlation between serum sFas and pathologic character: the cases with normal renal function were 29,including pathologic grades of the first second third fourth 2 14 8 5 respectly.There was not cases with grade of fifth.In this group,there were 24 cases (82.76%) with grades of the first second third and 5 cases (17.24%) with grade of the fourth. The cases with abnormal renal function were 26. Cases with grades of the first second thiixk fourtrK f...