The Level Changes And Clinical Significance Of OPN, MCP-1in Patients Serum With Diabetic Nephropathy Under The Regulation Of NF-κB Objective

ObjectiveDiabetic nephropathy is common microvascular complications of diabetes,the pathogenesis of the disease mechanism has yet to be fully elucidated.Recently studies suggest that, in addition to genetic susceptibility, as a mainfactor, metabolic disorders which induced by hemodynamic changes andvarious inflammatory factors lead to the development of diabetic nephropathy[1][2]. The ultimate cause is glomerular glomerulosclerosis and tubulointerstitialfibrosis. Nuclear factor kappa B (NF-kB) as the body of multiple cell nucleartranscription factor, can be stimulated by varieties of extracellular stimulationactivated, and then participate in the immune inflammatory response, mediatedregulation of the cell cycle and apoptosis. Under the pathological conditions,abnomal avtivity of NF kappa B cause diseases[3][4]. Osteopontin (OPN) issecreted by various types of cells and cell adhesion factors and chemokines[5],and lead to inflammatory reaction by chemotactic monocytes/macrophages[6].Also it can regulate podocyte cell signaling pathways which involved in proteinurine formation, leading to the occurrence and development of diabeticnephropathy. Monocyte chemoattractant protein1(MCP-1) have a critical rolein chemokine macrophage infiltration to glomerular and tubulointerstitial, alsoinvolved in the inflammatory response in diabetic nephropathy. The NF kappa Bas upstream factors directly regulate the OPN mRNA and MCP-1mRNAexpression, starting the amplification of the inflammatory response. This article through the detection of type2diabetic patients with peripheral bloodmononuclear cells of NF kappa B and serum OPN and MCP-1levels, and toanalyze the correlation of NF kappa B, under the control of OPN and MCP-1indiabetic nephropathy in the process of expression and significance.MethodsThe research object is divided into diabetic group and normal control group.1) diabetes group: Based on the urinary protein excretion rate,those will bedivided into urine protein negative group (group D0), microalbuminuria group(group D1) and clinical proteinuria group (D2group). D0group:34cases,24hour urine protein quantitative <30mg/24h; D1group:33cases,30mg/24h<24hour urine protein quantitative <300mg/24h; D2group:31cases,24hours urine protein quantity>300mg/24h;2) a control group:34cases, all self selected hospital medical center medical report qualifiedpersonnel.The diabetic group exclusion criteria: urinary system diseases (urinaryinfection, stones, nephritis, nephrotic syndrome), hypohepatia, rheumaticdisease, pregnancy, cancer, taking glucocorticoid, immunosuppressive drugsand renal toxicity drugs. In line with the DN staging criteria[7].Subjects of fasting from elbow vein blood, take24hour urine. HbA1c, BUN,Cr, Glu, TG, TC and biochemical laboratory determination; enzyme-linkedimmunosorbent assay (ELISA) for determination of serum NF-kB, OPN,MCP-1concentration; Determination of24hour urine protein quantitative.Reagent preparation and operation procedures in strict accordance withinstructions. Results1) difference between groups of NF kappa B levelThe level of NF kappa B in D0group was higher than in the normal controlgroup, and the difference was statistically significant (P <0.05). In the diabeticgroup, D2group was higher than in D1group, and D1group was higher than inD0group, and both had statistically significant (P <0.05).2) difference between groups of OPN levelSerum OPN concentration in D0group was significantly higher than normalcontrol group(P <0.01). In the diabetic group, serum OPN concentration in D2group was higher than in D1group, and D1group was higher than in D0group,and both had statistically significant (P <0.01).3) difference between groups of MCP-1levelSerum MCP-1concentration in D0group was significantly higher thannormal control group(P <0.01). In the diabetic group, serum MCP-1concentration in D2group was significantly higher than in D1group(P <0.05).But there was no statistically significant between D1group and D0group(P>0.01).4) correlation analysis:Serum OPN and NF-kB had correlation and the correlation coefficient was0.857(P <0.05). Serum MCP-1and NF-kB had correlation and the correlationcoefficient was0.728(P <0.05).The level of OPN, NF-B, MCP-1were significantly correlated with serumcreatinine, and the correlation coefficient were0.499,0.620,0.629(P <0.05);The level of OPN, NF-B, MCP-1were significantly related to urinary albumin excretion rate of urinary albumin, which correlation coefficient were0.748,0.859,0.677(P <0.05);ConclusionsThe level of NF-B, OPN, MCP-1had significantly increased in patientswith diabetic nephropathy diabetic groups, and significantly related to the urineprotein. The NF kappa B was related to MCP-1or OPN. As a critical factor in thedevelopment of diabetic nephropathy, NF-kB directly involve in the inflammatoryresponse and indirectly regulate of other inflammatory factor. Blocking theinflammatory factors activation and cascade maybe give assist to the treatmentof diabetic nephropathy.