The Correlation Of HMGB-1and NF-κB In Primary Nephritic Syndrome

Background:Primary nephrotic syndrome is a common immune inflammatory disease, However, the pathogenesis is still unknown. Several authors considered that immune-mediated and inflammatory injury plays the key role in the process of nephritic syndrome. A variety of inflammatory cytokines and immune response involved in the pathogenesis of kidney disease, and progression of the disease has a direct relationship. HMGB-1is a relatively new type of advanced Inflammatory cytokines, which exists in eukaryotic cells, both internally and externally. Related researches confirmed, HMGB-1in patients with chronic renal insufficiency, lupus nephritis, diabetic nephropathy, acute renal dysfunction, ANCA-associated vasculitis kidney damage, renal ischemia-reperfusion injury and other diseases showed high expression. In the study of signal transduction mechanisms confirmed, HMGB-1to its receptor RAGE, Toll-like receptors (Toll-like receptor, TLR2/TLR4) and other interactions, through the activation of MAPK, MyD88, and other ways to activate NF-κB (nuclear factor-kappa B, NF-κB), trigger an inflammatory response. A number of past studies have confirmed that NF-κB was highly expressed in primary nephrotic syndrome patients, and involved in the occurrence and development of primary nephrotic syndrome. However, at home and abroad on the primary nephrotic syndrome and inflammatory factor HMGB-1correlation has not been reported, the change in the serum of patients with primary nephrotic syndrome, analyse the correlation between HMGB-1and NF-κB, and the pathogenesis remains to be further studied.Objective:Determined the concentration of HMGB-1and NF-κB expressions of serum and analyzed the correlation between HMGB-1and NF-κB in primary nephrotic syndrome.Explore the role of HMGB-1and NF-κB in primary nephrotic syndrome pathogenesis.Method:From January2013to January2014,46patients (NS group) who were initial diagnosed with primary nephrotic syndrome were randomly selected, coupled with30cases of healthy volunteers as normal control group (NC group).Collect the two groups of patients with gender, age, serum albumin (AIB), cholesterol (Chol), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), urinary protein, C-reactive protein and other relevant clinical data, the concentration of HMGB-1and NF-κB in peripheral serumby ELISA. Pearson correlation analysis and multiple stepwise regression analysis for statistical were used.Result:1. The concentration of HMGB-1, NF-κB was significantly higher in NS group than in NC group. The difference between the two groups were statistically significant (P<0.01).2. Pearson correlation analysis showed that HMGB-1were significantly correlated positively with urinary protein, triglycerides, total cholesterol, low-density lipoprotein, C-reactive protein,negatively with serum albumin. NF-κB were significantly correlated positively with urinary protein, triglycerides, total cholesterol, low-density lipoprotein, negatively with serum albumin. Multiple stepwise regression analysis showed that HMGB-1was independently associated with urinary protein and NF-kB was independently associated with urinary protein.3. Multivariate analysis showed that the concentration of HMGB-1and NF-κB showed a positive correlation, the correlation coefficient=0.793, P<0.01, statistically significant. Conclusion:1. The expression levels of HMGB-1and NF-κB in nephrotic syndrome, they showed a positive correlation;2. HMGB-1may participate in the pathogenesis of primary nephrotic syndrome by influencing NF-κB3. Quantitative proteinuria is closely related to the inflammatory reaction in primary nephritic syndrome.