Expression and significance of NF-κB and HSP90 in renal puncture tissues and peripheral blood mononuclear cells of patients with lupus nephritis.

OBJECTIVES

Lupus nephritis (LN) is a common complication of systemic lupus erythematosus (SLE) that involves the kidneys and severely affects renal function or even leads to renal failure. The aim of this study was to quantify the expressions of nuclear factor kappa B (NF-κ B) and heat shock protein 90 (HSP90) in patients with LN and investigate the pathological mechanisms involved.

METHODS

We collected fifty-two renal needle biopsy tissues and complete clinical data from patients diagnosed with LN. We also selected thirty-two renal specimens from hydronephrosis surgery and autopsy served as the control group. The expressions of NF-κ B and HSP90 in kidney histology were detected. In addition, we collected Fasting peripheral venous blood samples from 16 patients with SLE, 12 patients with LN, and 16 healthy controls diagnosed in our hospital. And the gene expression levels of NF-κ B and HSP90 in peripheral blood mononuclear cells (PBMCs) of the subjects were determined.

RESULTS

The expression levels of NF-κ B and HSP90 in kidney histology of patients with LN were significantly higher than those in the control group. High NF-κ B and HSP90 protein expressions were associated with severe LN activity (SLEDAI >15 points) (p<0.05). Compared with the control group, the expression levels of NF-κ B and HSP90 mRNA were significantly up regulated in PBMCs of the SLE patient group (p<0.05). Moreover, the expression levels of NF-κ B and HSP90 mRNA in PBMCs were significantly up regulated in the LN patient group compared with the SLE patient group (p<0.05). In addition, the levels of NF-κ B and HSP90 mRNA expression in PBMCs of the LN patient group were positively correlated (p<0.05). The area under the receiver operating characteristic (ROC) curve for NF-κ B mRNA expression in PBMCs from patients with LN to diagnose SLE kidney damage was 0.929 (95% confidence interval [CI] 0.833-1.000, p<0.001), and the AUC for HSP90 mRNA expression was 0.742 (95% CI 0.556-0.927, p<0.05).

CONCLUSIONS

NF-κ B and HSP90 may play a synergistic role in the pathogenesis of LN. Their elevated expression has a high diagnostic accuracy for LN or SLE without renal damage. Hence, NF-κ B and HSP90 can be used as therapeutic targets and biomarkers for the diagnosis of LN.