다양한 사구체 질환자들의 소변에서 TGF-ß-inducible gene-h3(ßig-h3)의 발현 양상 = Urinary transforming growth factor -beta-inducible gene-h3 in patients with glomerular diseases

다국어 초록 (Multilingual Abstract)

=Background : Transforming growth factor-beta (TGF-β) has been implicated in the pathogenesis of a number of kidney diseases. However, TGF-β is secreted in a latent form requiring extracellular modification to become biologically active. Recently, the activity of TGF-β has been assessed by the measurement βig-h3, a novel TGF-β induced gene product. Thus we evaluated the pattern of urinary βig-h3 expression in various glomerular diseases. Methods : 64 patients with biopsy-proven primary glomerulonephritis (FSGS 6, HSPN 16, IgAN 20, MPGN I 7, and MesPGN 15), 10 patients with nephrotic syndrome and 12 healthy controls were enrolled in the study. A total 86 subjects (51 males, 59.3% and 35 females, 40.7%, mean age 13.9±4.28 years) constituted study population. First morning urine were collected and βig-h3 in the urine was determined by indirect competitive ELISA (Regen Biotech Inc, Seoul, Korea).Results : βig-h3 excretion was significantly higher in the urine from patients with HSPN (27.5±6.46, p=0.002), with IgAN (40.83±12.27, p=0.026), with MPGN I (21.64±7.29, p=0.042), MesPGN (26.42±6.68, p=0.007). In patients with FSGS (21.65±17.12) and minimal change nephrotic syndrome (6.26±2.18), mean urinary βig-h3 excretion was not significant higher than that in control group (3.56±0.78).Conclusion : Urinary βig-h3 excretion was high in proliferative renal diseases. However, βig-h3 excretion was not high in non-proliferative renal diseases.

국문 초록 (Abstract)

=다양한 사구체 질환자들의 소변에서 TGF-β-inducible Gene-h3 (βig-h3)의발현 양상가천의과대학교 길병원 소아과*,경희대학교병원 동서 신장병 연구소†, 리젠 바이오텍‡홍희주*·김성도†·이병철†윤희정‡·배은희‡·조병수†배 경 : TGF-β는 사구체 질환의 병리기전에서 매우 중요한 역할을 하는 사이토카인이다. TGF-β는 latent form으로 생성되어 생물학적 활성도를 갖는 형태로 변형되는데, 최근에 TGF-β-inducible gene-h3 (βig-h3)가 TGF-β에 의해 유도되는 유전자로 밝혀지고, 소변내 βig-h3의 발현이 신손상의 정도를 예측하는데 도움이 된다는 보고가 있어왔다. 이에 저자들은 여러 다양한 사구체 질환자들의 소변에서 βig-h3를 측정하여, 이 측정치와 각 질병들과의 상관 관계를 알아보고자 하였다.방 법 : 정상군 12명과 환자군 74명을 검사하였다. 대상 환자는 신장 조직 검사상 확진된 사구체 질환자들을 대상으로 하였으며, 질환별로 Ig A신염이 20명, 알레르기성 자반증 신염이 16명, 메산지움 증식성 사구체 신염이 15명, 1형 막증식성 사구체 신염이 7명, 초점성 분절성 사구체 경화증 6명, 미세 변화형 사구체 신증후군이 10명이었다. 소변내 βig-h3 측정은 indirect competitive ELISA (리젠 바이오텍) 방법으로 하였다. 결 과 : 소변내 βig-h3는 증식성 질환인 Ig A신염, 알레르기성 자반증 신염, 메산지움 증식성 사구체 신염, 1형 막증식성 사구체 신염에서 정상군보다 유의하게 높았다 (p<0.05). 비증식성 질환인 초점성 분절성 사구체 경화증, 미세 변화형 사구체 신증후군에서는 βig-h3의 유의한 상승이 없었다.

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