The Correlation Between The Level Of Macrophage Migration Inhibitory Factor And Clinic Pathology Of Membranous Nephropathy

Objective:Membranous nephropathy(MN)is an autoimmune disease characterized by the subepithelial deposition of Ig G and complement components in the glomerular capillary wall leading to clinical syndromes including massive proteinuria,hypoproteinemia,and thrombophilia.MN causes of death are mostly due to infection,cardiovascular events,leukopenia and other complications.Macrophage mobility inhibitory factor(MIF)is a soluble cytokine released by macrophages.MIF can attract macrophages to accumulate in inflammatory sites,inhibit their migration,and promote the proliferation,activation and secretion of certain cytokines,thus mediating kidney damage and causing kidney disease.Methods:We collected plasma and urine samples from 57 MN patients and 20 healthy blood donors,tested the concentration of MIF with commercial ELISA kit,and collected renal tissue samples from 5 of the above 57 patients.The expression of MIF was detected by immunohistochemical staining in 6 patients with renal resection.To analyze the relationship between plasma MIF、urine MIF and renal tissue MIF and clinicopathological indexes of MN patients.Results:We found that with the increase of plasma and urine MIF levels,the severity of renal pathological injury in MN patients increased gradually.Second,plasma MIF concentrations in MN patients were positively correlated with platelet(PLT)levels(r=0.302,P=0.022),was negatively correlated with prothrombin time(PT)(r =-0.292,P=0.028),and urine MIF concentration was positively correlated with activated partial thromboplastin time(APTT)(r =0.266,P=0.045),respectively.Analysis shows,Plasma MIF concentrations and C reactive protein(CRP)and erythrocyte sedimentation rate(ESR)(r=0.651,P<0.0001;r=0.669,P<0.0001)was positively correlated,Urine MIF concentration and ESR(r =0.562,P<0.0001)showed a positive correlation.We confirmed that the expression of MIF in renal tissue of MN patients was significantly higher than that of normal control group,especially in glomerular basement membrane and tubulointerstitial region.Conclusion : Plasma and urine MIF levels can reflect the severity of renal pathological injury in MN patients,and MN plasma and urine MIF levels may be associated with venous thrombosis and infection complications in MN patients.The expression of glomerular MIF can be used as one of the methods to judge the patient’s condition.