Erratum: Endoplasmic Reticulum Stress Predicts Clinical Response to Cyclosporine Treatment in Primary Membranous Nephropathy

Background: Little is known about the endoplasmic reticulum stress (ERS) marker glucose regulated protein 78 (GRP78) and calcineurin in the kidney in primary membranous nephropathy (PMN) and if they could predict post-cyclosporine treatment outcome. Methods: This is a retrospective study using a dataset of biopsy-confirmed PMN from Peking Union Medical College Hospital from 1996 to 2014. Seventy-six adult patients treated with cyclosporine as primary immunosuppression for at least 6 months were studied. Immunohistochemistry was used to detect GRP78 and calcineurin in the kidney. Serum calcineurin was assayed by ELISA. Patients were grouped into no-remission (NR, n = 17), partial remission (PR, n = 39), or complete remission (CR, n = 20) at the end of 6 months of treatment. Results: There was no difference of initial dose of cyclosporine among NR, PR, and CR groups. Kidney calcineurin expression in PMN was significantly increased compared to that in controls (p Conclusions: ERS marker GRP78 in the glomeruli but not serum or kidney calcineurin expression could be a useful marker in PMN to negatively predict the response to cyclosporine treatment at the sixth month.

背景：目前关于原发性膜性肾病（primary membranous nephropathy, PMN）患者肾脏中的内质网应激（endoplasmic reticulum stress, ERS）标志物葡萄糖调节蛋白78（glucose regulated protein 78, GRP78）与钙调神经磷酸酶（calcineurin），以及二者是否可预测环孢素（cyclosporine）治疗后的转归，相关研究仍较为匮乏。方法：本研究为回顾性研究，纳入1996年至2014年北京协和医院经肾活检确诊的原发性膜性肾病数据集。最终纳入76例以环孢素作为初始免疫抑制治疗、疗程至少6个月的成年患者作为研究对象。采用免疫组化法检测患者肾脏组织中GRP78与钙调神经磷酸酶的表达水平，通过酶联免疫吸附试验（enzyme-linked immunosorbent assay, ELISA）检测血清钙调神经磷酸酶水平。根据治疗6个月后的转归将患者分为无缓解组（no-remission, NR, n=17）、部分缓解组（partial remission, PR, n=39）与完全缓解组（complete remission, CR, n=20）。结果：无缓解组、部分缓解组与完全缓解组患者的初始环孢素给药剂量无显著差异。与对照组相比，原发性膜性肾病患者肾脏组织中的钙调神经磷酸酶表达水平显著升高（p。结论：肾小球内的内质网应激标志物GRP78，而非血清或肾脏组织中的钙调神经磷酸酶表达水平，可作为原发性膜性肾病患者接受环孢素治疗6个月时疗效的负向预测标志物。