Study on therapeutic effect characteristics of Liangxue Jiedu Huoxue method combined with western medicine on IgAV nephritis grade Ⅲ based on urinary proteomics
Objective:To explore the therapeutic effect of Liangxue Jiedu Huoxue method combined with western medicine on immunoglobulin A vasculitis nephritis(IgAVN)grade Ⅲ.Methods:Urine samples were collected from 20 children with IgAVN grade Ⅲ before and 1 month after treatment in the discovery cohort.The urine protein was determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS),and the differential proteins were screened and bioinformatics analyzed.In the validation cohort,the 24 h urinary protein(24h-UPRO),urine red blood cell(URBC)and the concentration of α 2-macroglobulin(A2M)in urine of 30 children with IgAVN grade Ⅲ was determined before and after treatment.Results:Fold change＞2 or＜0.5 and P＜0.05 were used as screening criteria for differential proteins.A total of 93 significantly up-regulated proteins and 72 significantly down-regulated proteins were obtained.Analysis showed that the differential proteins were significantly enriched in complement activation,classical pathway,positive regulation of apoptotic cell clearance,innate immune response,complement and coagulation cascades and intestinal immune network for IgA production pathways.After 1 month of treatment,the levels of 24h-UPRO,URBC were significantly lower than those before treatment(P＜0.01,P＜0.05).After treatment,the urinary A2M/Cr level significantly decreased(P＜0.01).Conclusion:Liangxue Jiedu Huoxue method combined with western medicine can inhibit immune and coagulation-related pathways.The pharmacological mechanism may be through inhibiting A2M,reducing the immune inflammation of IgAVN grade Ⅲ lesions and improving the hypercoagulability,and then reducing the urine protein and urine red blood cells,alleviating the renal injury.
Immunoglobulin A vasculitis nephritis(IgAVN)ProteomicsLiangxue Jiedu Huoxue methodImmune responseCoagulation
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