Potential diagnostic biomarkers for IgA nephropathy: a comparative study pre- and post-tonsillectomy

Int Urol Nephrol (2016) 48:18551861 DOI 10.1007/s11255-016-1372-2

NEPHROLOGY - ORIGINAL PAPER

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YingXin Xie1,2 LiYu He1 Xian Chen1 XiaoFei Peng1 MuYao Ye1 YuJing Zhao1 WenZhe Yan1 Chan Liu1 Jing Shao1 YouMing Peng1

Received: 11 April 2016 / Accepted: 11 July 2016 / Published online: 27 July 2016 Springer Science+Business Media Dordrecht 2016

(P < 0.05). However, in non-IgAN patients, tonsillectomy did not affect the mRNA levels of BAFF, ST6GALNAC2, C1GALT1, and COSMC, plasma IgA1 content and Gd-IgA1 level. Positive correlations were established between BAFF and IgA1 (r = 0.604, P < 0.01) and between

ST6GALNAC2 and Gd-IgA1 (r = 0.623, P < 0.01).

Conclusions Tonsillectomy changes the mRNA levels of BAFF, ST6GALNAC2, C1GALT1, and COSMC in PBMCs, as well as the plasma IgA1 level in IgAN patients. BAFF and ST6GALNAC2 might regulate IgA1 secretion and O-glycosylation.

Keywords IgA nephropathy Tonsillectomy BAFF IgA1

Introduction

Immunoglobulin A nephropathy (IgAN) is the most common type of primary glomerulonephritis [1]. As an immune complex-mediated glomerulonephritis, it is characterized by deposition of polymeric IgA (mainly IgA1) in the mesangium of the kidney [2]. The initial symptoms of IgAN are usually mild, including minimal proteinuria, but with stable renal function. However, up to 50 % of IgAN patients develop into end-stage renal disease within the next 20 years [3]. There is no available diagnosis biomarker for IgAN. Renal biopsy is still required to diagnose IgAN, but it is accompanied with invasive injury.

Tonsillectomy is an effective treatment for IgAN patients [46], although meta-analysis occasionally fails to conrm the effect [7, 8]. Tonsils are the rst line of defense against inhaled pathogens in the body and are the place of activation of tonsillar B cells and production of immunoglobulins, particularly polymeric IgA1. B

Abstract

Objective The proteins BAFF, ST6GALNAC2, C1GALT1, and COSMC in peripheral blood mononuclear cells (PBMCs) and plasma levels of IgA1 and galactose-decient IgA1 (Gd-IgA1) are potential biomarkers for IgAN nephropathy. In this study, we comparatively studied the changes of those biomarkers before and after tonsillectomy. Methods Peripheral blood samples were obtained from 16 IgAN patients with pre- and post-tonsillectomy. IgAN was diagnosed based on results from analysis of percutaneous renal...