The Clinical Significance Of CXCL12 And CXCR4 In Patients With Idiopathic Membranous Nephropathy

Objective: By detecting the levels of chemokine ligand 12(CXCL12)and chemokine receptor CXCR4 in patients with idiopathic membranous nephropathy(IMN),to explore the significance in the diagnosis and evaluation of IMN.Method: Participants were recruited from the third hospital of hebei medical university between March 2019 and December 2019,43 patients with IMN diagnosed by renal biopsy were selected as the observation group,14 patients with IgA nephropathy diagnosed by renal biopsy and 30 healthy people in a medical examination center during the same period were selected as the control group.The serum and urine levels of CXCL12 in each group were determined by enzyme-linked immuno sorbent assay(ELISA),the expression of CXCL12/CXCR4 in renal tissue of IMN patients and IgAN patients was detected by immuno-histochemistry,and then analyze the relationship between them with clinical indicators.Results:(1)There was no significant difference in age and sex ratio between the observation group and the control group(P> 0.05).(2)The expressions of CXCL12 in serum and urine in the IMN observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).The expressions of CXCL12 in serum and urine in the IgAN group were significantly higher than those in the healthy control group,with statistically significant differences(P<0.05).There was no significant difference in the levels of peripheral blood and urine CXCR4 between the patients in the IMN observation group and the control group(P> 0.05).(3)In the IMN observation group,the expression levels of CXCL12 in peripheral blood and urine were negatively correlated with serum albumin(r=﹣0.336,P=0.027;r=﹣0.339,P=0.026),which are positively correlated with urinary protein level(r=0.405,P=0.007;r=0.351,P=0.021)and the level of blood PLA2 R antibody(r=0.348,P=0.022;r=0.323,P=0.034).There was no significant correlation with serum creatinine level(P=0.620;P=0.606).(4)Compared with the IgAN control group,the expressions of CXCL12 and CXCR4 in renal tissues of patients in the IMN observation group were higher,and the difference was statistically significant(P <0.05).(5)The expression of CXCL12 and CXCR4 in renal tissue of patients in the IMN observation group was positively correlated with the levels of urinary protein(r=0.350,P=0.021;r = 0.389,P = 0.01),which are positively correlated with the level of blood PLA2 R antibody(r=0.447,P=0.003;r=0.361,P=0.017)and there was no significant correlation with serum albumin and serum creatinine level(P=0.614,P= 0.185;P=0.053,P= 0.770).Conclusions:The expression of CXCL12/CXCR4 in serum,urine and renal tissue of IMN patients was increased,which was related to the disease condition of IMN patients,suggesting that CXCL12/CXCR4 may be involved in the development of IMN,and the condition of IMN patients could be evaluated by monitoring the level of CXCL12/CXCR4.