Effects Of Vitamin D Combined With Hydroxychloroquine On Treatment Of IgA Nephropathy Rats

Objective To establish IgA nephropathy?IgAN?rats model and to investigate the effect of vitamin D and hydroxychloroquine combined treatment on the improvement of kidney pathology,IgA deposition and the expression of Toll-like receptor 4?TLR4?and Ki67 in the kidney of IgAN rats.Methods Forty Wistar rats were randomly distributed to five groups:Control group,IgAN group,Vit D group,HCQ group,and VitD+HCQ group,N=8 rats/group.The rats in IgAN group and three treatment groups were established to be IgAN model according to the methods of BSA+castor oil+LPS+CCl₄.Vitamin D was given to rats in the VitD group for 8 weeks,hydroxychloroquine was given to rats in the HCQ group for 8 weeks,and vitamin D and hydroxychloroquine were given to rats in the VitD+HCQ group for 8weeks.Hematoxylin-eosin staining and Masson staining were used to observe the pathological changes and renal fibrosis.The deposition of IgA in the mesangial region was detected by direct immunofluorescence.Immunohistochemical staining was used to observe the expression of TLR4 and Ki67 in renal tissues.Results 1)IgAN rats model were successfully established.2)Compared with the control group,inflammatory cells,the degree of glomerular atrophy and renal fibrosis,IgA deposition in the mesangial area,and the expression of TLR4 and Ki67 in the renal tissues were increased in the IgAN group and the three groups treated with drugs,with statistically significant differences?P<0.05?.3)Compared with the IgAN group,the pathological performances of the three groups under drug treatment are all improved.VitD group showed mildly glomerular atrophy,decreased IgA deposition in the mesenchymal region and reduced expression of TLR4?P<0.05?.4)Compared with the IgAN group,both the HCQ group and the VitD+HCQ group showed slightly glomerular atrophy and renal fibrosis,fewer IgA deposition in the mesangial region and lower expressions of TLR4 and Ki67 in the kidneys?P<0.05?.5)Compared with VitD group and HCQ group,VitD+HCQ group had significantly fewer inflammatory cells,no obviously glomerular atrophy,and decreased degree of fibrosis and lower expression of TLR4 and Ki67?P<0.05?.Conclusion 1.The combination treatment of vitamin D and hydroxychloroquine can reduce renal inflammation,glomerular atrophy and renal fibrosis in IgAN rats.2.The combination of vitamin D and hydroxychloroquine can alleviate IgA deposition in the kidney of IgAN rats.3.Vitamin D combined with hydroxychloroquine can decrease the expression of TLR4 and Ki67 in kidneys of IgAN rats.4.Vitamin D or hydroxychloroquine alone can also improve renal pathological damage in IgAN rats,but the combined treatment is more effective.