Abstract
BackgroundTumor necrosis factor alpha (TNF-α) is considered to play an important role in the pathogenesis in IgA nephropathy (IgAN). The correlations between serum TNF-α and disease severity in patients with IgAN remain controversial.MethodsConcentrations of serum TNF-α of 147 patients with IgAN and 126 healthy subjects were measured by chemiluminescence immunoassay. Correlations with clinicopathological features of patients with IgAN were evaluated.ResultsSerum levels of TNF-α [9.20 (7.70–10.60) pg/mL vs. 6.04 (5.11–7.23) pg/mL, P < 0.0001] were higher in patients with IgAN than that in healthy subjects. Receiver operating characteristic curve analysis revealed that TNF-α had better discrimination between patients with IgAN and healthy controls than estimated glomerular filtration rate [TNF-α: (AUC, 0.87; 95% CI, 0.83–0.91; P < 0.0001) vs. estimated glomerular filtration rate: (AUC, 0.76; 95% CI, 0.71–0.82; P < 0.0001), P = 0.007]. Multivariate linear regression analyses showed that serum levels of TNF-α were positively correlated with 24-h urine protein excretion (r = 0.33, P = 0.04), urinary protein to serum creatinine ratio (r = 0.33, P = 0.03), serum creatinine (r = 0.46, P < 0.0001) and Cystatin C (r = 0.59, P < 0.0001) in IgAN and negatively correlated with estimated glomerular filtration rate (r = − 0.49, P < 0.0001) after adjustment for sex, systolic blood pressure and diastolic blood pressure. Patients with higher mesangial hypercellularity or tubular atrophy/interstitial fibrosis score according to Oxford classification showed higher serum levels of TNF-α.ConclusionsOur data showed that serum levels of TNF-α detected by chemiluminescence immunoassay was a potential biomarker for evaluating the disease severity in IgAN.
Highlights
Tumor necrosis factor alpha (TNF-α) is considered to play an important role in the pathogenesis in IgA nephropathy (IgAN)
Multivariate linear regression analyses showed that serum levels of tumor necrosis factor-α (TNF-α) were positively correlated with 24-h urine protein excretion (r = 0.33, P = 0.04), urinary protein to serum creatinine ratio (r = 0.33, P = 0.03), serum creatinine (r = 0.46, P < 0.0001) and Cystatin C (r = 0.59, P < 0.0001) in IgAN and negatively correlated with Estimated glomerular filtration rate (eGFR) (r = − 0.49, P < 0.0001) after adjustment for sex, systolic blood pressure (BP) and diastolic BP (Table 3)
Serum TNF-α correlated with mesangial hypercellularity and tubular atrophy/interstitial fibrosis according to Oxford classification in IgAN
Summary
Tumor necrosis factor alpha (TNF-α) is considered to play an important role in the pathogenesis in IgA nephropathy (IgAN). Hypertension, renal dysfunction, and histological features recently updated Oxford classification have been identified as clinicopathological markers for disease severity and poor prognosis of IgAN [4, 5]. These factors are numerous and controversial, and do not always have the specificity to. It is considered that cytokines such as tumor necrosis factor-α (TNF-α) play an important role in aberrant mucosal immune response in the early phase of the pathogenesis in IgAN [11, 12], and mesangial cell proliferation, hyperproduction of extracellular matrices, podocyte injury and glomerulosclerosis in the second phase [13]. Serum TNF-α may be a potential biomarker for severity in IgAN
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