Cross-sectional Study on the Correlation Between Chinese Medicine Syndrome Types and Mucosal Immunity in IgA Nephropathy
Objective To explore the Chinese medicine(CM)syndrome classification and its correlation with mucosal immunity in patients with IgA nephropathy(IgAN).Methods A cross-sectional study was performed,including 410 patients with IgAN.The data of CM syndrome were collected,and the CM syndrome classification was summarized by factor analysis and cluster analysis.Serum levels of galactose-deficient IgA1(Gd-IgA1)and mucosal immune-related markers,including B cell activating factor(BAFF),a proliferation inducing ligand(APRIL),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were measured in 118 patients.The correlation between serum Gd-IgA1 levels in different CM syndromes and these mucosal immune-related markers was analyzed.Results A total of 51 symptoms,tongue images and pulse images closely related to IgAN syndromes were collected,and 13 common factors with eigenvalues greater than 1 could be extracted,which could be clustered into 4 categories.The CM syndromes of IgAN patients were classified as Fei-Pi qi-deficiency syndrome in 186 cases(45.36％),Gan-Shen yin-deficiency syndrome in 102 cases(24.88％),Pi-Shen yang-deficiency syndrome in 79 cases(19.27％),and Gan qi depression syndrome in 43 cases(10.49％).The serum Gd-IgA1 levels of patients with Fei-Pi qi-deficiency syndrome was 6.09(4.44,7.00)µg/mL,which was significantly higher than that of patients with other CM syndromes(P＜0.01).Gd-IgA1 levels were elevated in patients with IgAN at different sites of mucosal inflammation compared with patients without mucosal inflammation(P＜0.01).Serum Gd-IgA1 levels in IgAN patients demonstrated correlations with mucosal immune-related markers APRIL,IL-6 and TNF-α(P＜0.05).Conclusions The prevalent clinical CM syndromes in IgAN patients are Fei-Pi qi-deficiency syndrome,Gan-Shen yin deficiency syndrome,Pi-Shen yang-deficiency syndrome,and Gan qi depression syndrome.Fei-Pi qi-deficiency syndrome is most closely associated with abnormal mucosal immunity in IgAN.
IgA nephropathyChinese medicine syndromemucosal immunityGalactose-deficient IgA1integrative medicine
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