Correlation Of Polycyclic Aromatic Hydrocarbons And Idiopathic Membranous Nephropathy Through Oxidative Stress

Background and ObjectiveWith the rapid development of society and economy,the intensification of population aging and the adjustment of lifestyles,the incidence of chronic diseases is getting higher and higher,which has become an important issue threatening human health.Chronic kidney disease(CKD)has become one of the major chronic diseases in the country’s prevention and control due to its high incidence,high fatality rate and high medical costs.Membranous nephropathy(MN)is one of the common causes of chronic kidney disease.In recent years,the prevalence of membranous nephropathy has increased significantly,and it has become the second major pathological type of primary glomerulonephritis.The research on membranous nephropathy has become a hot issue in the field of nephropathy.With the emphasis on the environment,fine particulate matter(PM2.5)and its relationship with chronic diseases have attracted more and more attention.It has been confirmed that PM2.5 increases the risk of cardiovascular,cerebrovascular and respiratory diseases,and is also closely related to the increase in the incidence of membranous nephropathy.Polycyclic aromatic hydrocarbons(PAHs)are one of the main components of PM2.5.Our team’s early cell experiments found that polycyclic aromatic hydrocarbons can cause podocyte damage,which may be one of the pathogenesis of membranous nephropathy.In addition,we have confirmed that oxidative stress is involved in the occurrence of membranous nephropathy.It is not clear whether polycyclic aromatic hydrocarbons cause podocyte damage through oxidative stress.Based on the above background,this study carried out the detection of polycyclic aromatic hydrocarbons and oxidative stress indicators for idiopathic membranous nephropathy(IMN),and analyzed the relationship between PAHs,oxidative stress and IMN,explored the role that PAHs may play in the occurrence and development of IMN,and provided new ideas for the pathogenesis,diagnosis,and prevention and treatment of kidney disease caused by PAHs and PM2.5.MethodsThe patients who received renal biopsy in the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University from June 1,2020 to September 30,2020 were selected and diagnosed as IMN or secondary MN(SMN)or minimal change disease(MCD)by pathology.The demographic data,clinical data and pathological data of the patients were recorded.The blood samples were collected for the detection of PAHs concentration and the levels of superoxide dismutase 2(SOD2)and heme oxygenases-1(HO-1),and statistical methods were used to analyze the differences and correlations between groups.Results1.IMN group has 21 males and 9 females.The male to female ratio is 2.33:1,and the age is 25 to 70 years old.The age distribution is dominated by people over 40 years old,and 30%of people younger than 40 years old.2.There are differences in the blood PAHs concentration between the three groups(F=6.122,P=0.004).Further analysis showed that the blood PAHs concentration of the IMN group was higher than that of the SMN group and the MCD group,and the difference was statistically significant(P<0.05).There was no difference between SMN group and MCD group.3.The concentration of blood PAHs is positively correlated with β2 microglobulin,total cholesterol and 24-hour urine total protein,and negatively correlated with serum total protein,albumin and IgG levels in IMN group.The results of grouping IMN by urine protein level showed that the blood PAHs concentration in the high-level group(24hTP>8g)was significantly increased.4.The level of HO-1 is negatively correlated with serum creatinine,cystatin C,total cholesterol,triglycerides,24-hour urine protein quantification and β2 microglobulin levels,and positively correlated with estimated glomerular filtration rate,serum total protein,albumin and IgG levels in IMN group.5.The concentration of PAHs in blood was significantly negatively correlated with the level of HO-1(r=-0.381,P=0.019).Linear regression analysis showed that every time the concentration of PAHs increased by lmg/L,the level of HO-1 decreased by 2μg/L.ConclusionThe concentration of PAHs in patients with IMN is elevated,and it is closely related to the oxidative stress indicator HO-1 and the clinical indicators of the degree of disease such as 24-hour urine total protein and serum albumin.It is speculated that PAHs participate in the occurrence and development of IMN through oxidative stress.