The expression of SOX2,SIRT1,and sIL-2R in the serum of patients with idiopathic membranous nephropathy and their correlation with clinical staging and prognosis

Sun Haoyue; Jin Yanhua; Wang Huan; Zhang Yanning; Fu Han

doi:10.3969/j.issn.1671-6450.2025.04.015

Abstract：Objective To investigate the expression of sex determining region Y box protein 2(SOX2),silent infor-mation regulator 1(SIRT1),and soluble interleukin-2 receptor(sIL-2R)in the serum of patients with idiopathic membranous nephropathy(IMN),and their correlation with clinical staging and prognosis.Methods A total of 316 IMN patients admit-ted to the Nephrology Department of the Northern Theater General Hospital of the Chinese people's Liberation Army from January 2021 to January 2023 were selected as IMN group.According to the prognosis,they were divided into poor prog-nosis subgroup(86 cases)and good prognosis subgroup(230 cases);Another 316 cases of healthy physical examination in the same period were selected as the healthy control group.Enzyme linked immunosorbent assay(ELISA)method was per-formed to detect serum SOX2,SIRT1,and sIL-2R.Receiver operating characteristic curve(ROC)method was used to analyze the predictive value of serum SOX2,SIRT1,and sIL-2R detection for the prognosis of IMN patients.Multivariate Logistic re-gression was used to analyze the influencing factors of poor prognosis in patients.Results Compared with the healthy control group,the SOX2 and sIL-2R in the IMN group were conspicuously higher,and SIRT1 was prominently lower(t/P=34.115/＜0.001,28.962/＜0.001,13.579/＜0.001).The levels of SOX2 and sIL-2R in phase Ⅲ were higher than those in phaseⅡ and higher than those in phase Ⅰ,and the levels of SIRT1 in phase Ⅲ were lower than those in phase Ⅱ and lower than those in phase Ⅰ(F/P=8.309/＜0.001,10222/＜0.001,4214/0.016).Compared with the good prognosis subgroup,the serum creatinine,proportion of glomerulosclerosis,SOX2,sIL-2R levels in the poor prognosis subgroup were significantly increased,and the SIRT1 level was significantly decreased(t/P=12.024/＜0.001,12.877/＜0.001,8.522/＜0.001,7.147/＜0.001,6.599/＜0.001).The AUC of serum SOX2,SIRT1,sIL-2R and their combination in predicting the prognosis of IMN patients were 0.753,0.733,0.768 and 0.863,respectively,and the combined AUC of the three was better than that of their individual prediction(Z/P=3.904/＜0.001,2.652/0.008,4.770/＜0.001).High serum creatinine,glomerulosclerosis,SOX2 and sIL-2R were the influencing factors of poor prognosis in IMN patients,and high SIRT1 was an independent protective factor[OR(95％CI)=2.254(1.346-3.774),3.474(1.877-6.429),2.362(1.441-3.871),1.854(1371-2507),0.698(0567-0.859)].Conclusion The se-rum SOX2 and sIL-2R in IMN patients are conspicuously increased,while the SIRT1 is conspicuously decreased,and all are closely related to clinical staging and prognosis.