EXPRESSION OF SERUM TNFR1 AND TNFR2 IN PATIENTS WITH IDIOPATHIC MEMBRANOUS NEPHROPATHY AND THEIR RELATIONSHIP WITH CLINICOPATHOLOGICAL PARAMETERS AND PROGNOSIS

Objective: To analyse the expression of tumour necrosis factor receptor-l (TNFRl) and tumour necrosis factor receptor-2 (TNFR2) in the serum of patients with idiopathic membranous nephropathy and their relationship with the clinicopathological parameters and prognosis. Methods: Patients with idiopathic membranous nephropathy that were treated in our hospital during the timeframe of January 2015 to February 2016 were selected as part of the IMN group (n = 88), patients with non-idiopathic membranous nephropathy who had renal biopsy at the same time were selected as part of the non-IMN group (n = 50), and healthy adults who had a physical examination acted as a control group (n = 45). The levels of serum creatinine, glomerular filtration rate, serum albumin, 24h urinary protein (24hpro), and TNFR1 and TNFR2 were compared among the three groups. After treatment, the IMN patients were divided into 24hpro <3.5g group (n = 30), 24hpro >= 3.5g group (n = 58), and the quantitative relationship between TNFR1, TNFR2, and 24h urinary protein was analysed. After treatment, the IMN patients were divided into complete remission group (n = 42), partial remission group (n = 28) and ineffective group (n = 18), according to the 24hpro level. The relative expression levels of TNFR1 and TNFR2 were also analysed. Results: Compared with the control group, the serum albumin level of the IMN group and non-IMN group was significantly lower, and the 24hpro was significantly higher (P<0.05). When compared with the non-IMN group, the serum albumin level of the IMN group was significantly lower, and the 24hpro was significantly higher (P<0.05). There was no significant difference in the serum creatinine and glomerular filtration rate among the three groups (P>0.05). Compared with the control group, the relative expression level of the TNFR1 and TNFR2 in both the non-IMN group and IMN group increased significantly (P<0.05); compared with the non-IMN group, the relative expression level of TNFR1 and TNFR2 in the IMN group was seen to increased significantly (P<0.05). There was no significant difference in the relative expression of TNFR1 and TNFR2 between the control group and the IMN group (P>0.05). In contrast, a comparison with the control group showed that the relative expression level of TNFR1 and TNFR2 in stage III and IV patients were significantly higher (P<0.05). Compared with the < 3.5g group, the expression levels of TNFR1 and TNFR2 in >= 3.5g group were also significantly higher (P<0.05). There was a positive correlation between the expression of the TNFR1 and TNFR2 and 24-hour urine protein. Compared with the complete remission group, the relative expression levels of TNFR1 and TNFR2 in the partial remission group and the ineffective group were also significantly higher (P<0.05).Finally, when compared with the partial remission group, the relative expression levels of TNFR1 and TNFR2 in the ineffective group were significantly higher (P<0.05). Conclusion: The relative expression level of TNFR1 and TNFR2 in the serum of patients with idiopathic membranous nephropathy is significantly increased, and the expression of TNFR1 and TNFR2 is correlated with the pathological stage, 24hpro, and prognosis of patients. This may be an important biomarker for evaluating the occurrence, development, and prognosis of idiopathic membranous nephropathy.