Study On The Correlation Between Wnt4 And The Severity Of Renal Interstitial Fibrosis

Renal interstitial fibrosis(RIF)is a common pathological process from chronic kidney disease(CKD)to end-stage kidney disease(ESRD).It is characterized by the deposition of Extracellular Matrix(ECM),excessive aggregation of activated myofibroblasts and inflammatory cell infiltration.At present,the research on RIF mechanism is increasing.Wnt4 is a secreted glycoprotein,which plays an important role in renal RIF.At present,the mechanism of delaying RIF is still unclear.6Therefore,the purpose of this study aimed to explore the relationship between Wnt4 and renal interstitial fibrosis in patients with chronic kidney disease,and to provide ideas for further study of renal interstitial fibrosis.Objective : The purpose of this study was to study the correlation between the expression intensity of Wnt4 in kidney and the level of Wnt4 protein in urine and the severity of RIF in CKD patients.Methods:Patients who were diagnosed with CKD in the Department of Nephrology of Shaanxi Provincial People’s Hospital from March 2019 to October 2020 and underwent kidney puncture biopsy were selected as the experimental group and the normal tissues adjacent to renal cancer were selected as the normal control group.The patients were scored semi-quantitatively according to the renal tubular injury score and divided into mild,moderate and severe interstitial fibrosis.The correlation between the expression level of Wnt4 in renal tissues and the severity of RIF was evaluated by immunohistochemical(IHC).Patients who were diagnosed with CKD and underwent kidney puncture biopsy in the Department of Nephrology of Shaanxi Provincial People’s Hospital from September 2019 to June 2020 were collected as the experimental group and healthy volunteers as the normal control group.Urine samples were collected and the levels of Wnt4 protein in the urine of patients in the experimental group were detected by enzyme-linked immunosorbent assay(Elisa).The samples were semi-quantitatively scored according to the renal tubular injury score,which was divided into mild,moderate and severe interstitial fibrosis.The correlation between Wnt4 protein level in the urine and the severity of RIF was analyzed.SPSS 26.0 software was used for statistical analysis.Results:1.Correlation between expression of Wnt4 in renal tissue and severity of RIF1.1 There were no significant differences in age,gender,Serum Creatinine,Scr),Blood urea nitrogen,BUN),uric acid(UA),total cholesterol(TC),and triglyceride(TG)among the different groups(P > 0.05).The expression of Wnt4 in renal tissues of different groups was statistically significant(P < 0.05).The expression of Wnt4 in renal tissues was statistically significant in the non-pathological group and the severe interstitial injury group,as well as in the mild interstitial injury group and the severe interstitial injury group.1.2 The relationship between the expression level of Wnt4 in renal tissue and clinical indicators was analyzed by Spearman correlation analysis.The results showed that the expression level of Wnt4 in renal tissue was positively correlated with the interstitial injury score(r=0.318,P < 0.05).That is to say,the more severe the interstitial injury was,the stronger the expression level of Wnt4 in renal tissue would be.A little expression of Wnt4 was observed in the renal tissues of the normal control group.With the aggravation of interstitial injury,the expression intensity of Wnt4 in the renal tissues was significantly increased,and the area was gradually enlarged and the color was gradually deepened.2.Analysis of urinary Wnt4 protein and RIF severity2.1In different degrees of RIF,there were significant differences in Scr,BUN,estimated glomerular filtration rate(e GFR)and urine Wnt protein level(P < 0.05),among which,the pairwise comparison of Scr showed that the P values of grade 0 and grade 2,grade 0 and grade 3 interstitial damage were < 0.05,showing statistical differences.Age,UA,TC and TG were not statistically significant.There was significant statistical difference in urinary Wnt4 protein concentration between the experimental group and the healthy control group(P < 0.05).2.2 Analysis of urine Wnt4 protein concentration and clinical indicators in the experimental group by Spearman correlation analysis showed that urine Wnt4 protein concentration had a negative correlation with e GFR(r =-0.811,P < 0.05),and a positive correlation with Scr(r=0.572,P < 0.05),BUN(r=0.509,P < 0.05),and the degree of interstitial damage(r=0.586,P < 0.05).Therefore,the urinary Wnt4 protein concentration in patients with CKD was significantly correlated with the degree of renal interstitial fibrosis,that is,the more severe the renal interstitial injury was,the higher the urinary Wnt4 protein concentration would be.Conclusion:1.The expression of Wnt4 in renal interstitial fibrosis is significantly higher than that in normal renal tissue without fibrosis.2.The expression of Wnt4 in renal tissue is correlated with renal interstitial fibrosis,and the more severe the degree of renal interstitial fibrosis,the stronger the expression of Wnt4.3.There is a correlation between urinary Wnt4 concentration and renal interstitial fibrosis,and the more severe renal interstitial fibrosis,the higher urinary Wnt4 concentration.