关键词: 肾小球肾炎, IgA, 糖尿病, 循环免疫复合物

Abstract: Background　IgAN is one of the most common primary glomerular diseases worldwide，and it is recognized that the deposition of circulating immune complexes in the glomerular mesangial area initiates the disease.Likewise，the incidence of diabetes mellitus（DM） in China has increased year by year，which has become a major national health problem.Objective　Circulating immune complex （CIC） could promote proliferation and inflammation factors production of glomerular mesangial cells in patients with IgA nephropathy （IgAN），we aimed to investigate if there is functional difference of CIC from patients both with IgAN and DM.Methods　28 patients with primary IgAN （8 both with IgAN and DM，and 20 with IgAN only） who received renal-biopsy in the First Affiliated Hospital of Zhengzhou University were recruited from February 2017 to February 2018.In addition，7 age- and sex-matched physical examinees （as healthy controls） were recruited from the physical examination department of this hospital during the period.Clinical and pathological data of patients with IgAN were collected from medical records.CIC was extracted from 10 ml peripheral blood collected from all participants and was used to stimulate the glomerular mesangial cells at the same concentration，then the mesangial cell proliferation activity was detected by CCK-8 kit and the levels of IL-6 and CXCL1 in the supernatant were tested by commercial ELISA kits.Results　The plasma levels of triglyceride，C3 and C4 in the IgAN group were lower than those both with IgAN and DM.The ratio of patients with E1 （capillary endothelial cell proliferation） in the Oxford classification was higher than that in the IgAN with DM group （P<0.05）.The proliferation activity of the mesangial cells in the three groups was significantly different （P<0.001），in particular，it was higher in the IgAN group than that of other two groups （P<0.05），but there was no significant difference between the IgAN with DM group and the normal group （P=0.250）.As to cell supernatant IL-6 and CXCL1 levels，the result showed there was no difference among the three groups （P>0.05）.Conclusion　It is seemly CIC from patients with both IgAN and DM have the similar ability to promote mesangial cells to produce inflammatory factors as the ones only with IgAN，but lower ability on promoting the proliferation of mesangial cells，which indicated the component of CIC may be different between patients with IgAN only and both with DM.

Key words: Glomerulonephritis, IgA；Diabetes mellitus；Circulating immune complex