利用磁珠分离联合MALDI-TOF-MS技术判定早期IgA肾病的病理表现

目的利用尿蛋白质组学的新方法，寻找无创性尿液标记物，用以判断临床早期IgA肾病的病理表现。方法对55例早期IgA肾病患者[其中23例病理表现较重（重病理损伤组），32例病理表现较轻（轻病理损伤组）]及14例病理检查完全正常者（正常对照组）的尿液，利用阳离子磁珠分离技术联合基质辅助激光解吸／电离飞行时间质谱法（MALDI-TOF-MS）分析尿液蛋白质质谱。结果建立了3个尿蛋白质／多肽模型。发现潜在的生物标志物及其诊断模型可以区分重病理损伤组和轻病理损伤组，其敏感性和特异性分别为90．48％和96．77％。区分轻病理损伤组和正常对照组的诊断模型，其敏感性和特异性分别为9355％和85-71％。区分重病理损伤组和正常对照组的诊断模型，其敏感性和特异性分别为100％和9286％。结论利用磁珠分离联合MALDI-TOF-MS的尿蛋白质组技术在判定早期IgA肾病的病理表现显示出较大潜力。

Identification of the pathologic presentation of clinical early IgA nephropathy by MALDI-TOF-MS with magnetic beads

Objective To search noninvasive methods to identify the pathologic presentation of early IgA nephropathy through urinary proteomic analysis. Methods Total 55 patients with IgA nephropathy were included in this study, with 23 patients having severe pathologic presentation, and the other 32 having mild ones. The control group included 14 normal subjects. The urinary proteomic spectra from those three groups were generated by Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF-MS） with weak cationic exchange magnetic beads. Results Three Urine protein/peptide spectra patterns were established. In pattern one, the potential protein biomarkers could identify the severe group and the mild group, the sensitivity was 90.48% and the specificity was 96.77%. In pattern two, the potential protein biomarkers could identify the mild group and the normal group, the sensitivity was 93.55% and the specificity was 85.71%. In pattern three, The potential protein biomarker could identify the severe group and the normal group, the sensitivity was 100% and the specificity was 92.86%. Conclusion Using MALDI-TOF-MS with magnetic beads to detect urine proteomic patterns shows great potential in identifying early IgA nephropathy with different pathological manifestations.