Expression and clinical significance of thrombospondin-1 and plasminogen activator inhibitor-1 in patients with mesangial proliferative glomerulonephritis

Background: As a common pathological type of glomerular disease in China, mesangial proliferative glomerulonephritis is related to plasminogen activator inhibitor-1 (PMI-1) and thrombospondin-1 (TSP-1). Here, this study aims to investigate the expression and clinical significance of TSP-1 and PAI-1 in patients with mesangial proliferative glomerulonephritis. Methods: Renal tissue specimens from 46 patients with mesangial proliferative glomerulonephritis admitted to this hospital were selected as the subjects, and 8 specimens of renal tissue from autopsy were used as controls. The expression levels of TSP-1 and PAI-1 were detected by immunohistochemistry and analyzed. Results: The 24-hour urine protein, triglyceride, and total cholesterol levels of patients with severe mesangial hyperplasia were significantly higher than those of patients with mild and moderate mesangial hyperplasia, and serum albumin was lower than that of patients with mild and moderate mesangial hyperplasia (P<0.05). The 24-hour urine protein level of patients with moderate mesangial hyperplasia was higher than that of patients with mild mesangial hyperplasia while the albumin level was lower (P<0.05), but there was no significant difference in triglyceride and total cholesterol (P>0.05). There was no significant difference in creatinine clearance (Cer) between the three groups (P>0.05). The 24-hour urine protein and urine alpha-l-microglobulin (A1M) levels in patients with renal interstitial disease were higher than those in patients without renal interstitial disease, while their Ccr level was lower (P<0.05). TSP-1 and PAI-1 were not positively expressed in the glomeruli and renal tubules of specimens of the control group. However, in mesangial hyperplasia patients, the expression of TSP-1 and PAI-1 in mesangial hyperplasia with varying degrees and in different renal tubular damage were as follows: mild degree < moderate degree < severe degree (P<0.05). Conclusions: The pathological changes of mesangial proliferative glomerulonephritis are related to 24-hour urine protein, triglyceride, total cholesterol level, urine AIM, and Ccr level. The expression of TSP-1 and PAI-1 in the mesenchyme of glomerular and renal tubules significantly increased with the severity of the disease, suggesting that TSP-1 and PAI-1 play an important role in the occurrence and development of mesangial proliferative glomerulonephritis.