肾组织粘附分子及树突状细胞与IgA肾病小管间质病变的关系  

Relationship between adhesion molecules and dendritic cells in the tubulointerstitial lesions of IgA nephropathy

作　　者：周同[1] 孙桂芝[1] 李晓[1] 吴开胤[1] 张冬青[2] 陈玉英[3] 胡庆沈[3] 陈楠[1] 

机构地区：[1]上海第二医科大学瑞金医院肾内科 [2]上海第二医科大学上海市免疫学研究所 [3]上海第二医科大学细胞生物学教研室,上海200025

出　　处：《肾脏病与透析肾移植杂志》2004年第6期530-533,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金 (NO :3 9970 3 40 );上海市自然科学基金 (NO :0 2ZB14 0 41;0 3 4119916)

摘　　要：目的 :观察粘附分子P 选择素与树突状细胞 (DC)在IgA肾病 (IgAN)患者肾组织中的表达与分布 ,探讨P 选择素及DC与肾小管间质病变以及肾功能损害的关系。　 方法 :选择经肾活检和临床资料确诊的IgAN患者 4 5例 ,根据小管间质病变程度分为 3组 :轻度组 2 9例 ,中度组 10例 ,重度组 6例 ;10例正常人肾组织作为对照。采用免疫组化法观察IgAN患者肾组织中P 选择素表达 ;免疫双标记染色与荧光图像分析法 ,观察CD1a+ CD80 + DC在肾组织中的分布 ,并探讨DC与患者肾小管间质病变及肾功能损害的关系。　 结果 :①P 选择素在正常肾组织中基本不表达 ,在IgAN肾组织中以肾小管上皮细胞为主广泛高表达 ,重度组肾小管间质表达明显强于轻、中度组 ,且与肾小管间质病变程度轻重显著相关。②正常人肾组织中基本未见CD1a+ CD80 + DC分布 ,IgAN肾组织中以肾小管间质为主分布明显增多 ;其在患者肾小管间质的分布于重度组明显高于轻、中度组 ,亦与肾小管间质病变程度及血肌酐显著相关。此外 ,CD1a+ CD80 + DC在患者肾小管间质分布与P 选择素表达明显相关。　 结论 :P 选择素尤其DC可能参与了IgAN肾小管间质病变的免疫病理损伤机制 ,且推测DC肾炎组织迁移聚集可能与P 选择素介导有关。Objective:To observe the expression of P-selectin and the localization of dendritic cells(DCs) in human kidney with IgA nephropathy, and to evaluate their function in human renal tubulointerstitial lesions and renal dysfunction. Methodology:We choosed biopsy specimen of 45 patients with IgA nephropathy, which were divided into three group according as the degree of renal tubulointerstitial lesions: mild group(n=29), moderate group(n=10), severe group(n=6). 10 normal individuals were severed as control. The expression of P-selectin was analysed by immunohistochemistry. CD1a+CD80+DC was investigated by double immunostaining method and the images were analyzed with Axioplan 2 microscopy. Results:①P-selectin was not expressed in normal controls, but presented in renal tubular epithelial cells, which was greater in severe group than mild and moderate groups. The expression of P-selectin was associated with the degree of renal tubulointerstitial lesions. ② CD1a+CD80+DC was hardly observed in nomal renal tissues. But in renal tissues of patients with IgA nephropathy, CD1a+CD80+DC was mostly found in renal tubulointerstitium. The distribution area, number and density of CD1a+CD80+DC in severe group was much more than other groups, which was associated with the degree of renal tubulointerstitial lesions and the lever of serum creatine. The distribution of CD1a+CD80+DC was associated with the expression of P-selectin in patient's renal tubulointerstitium. Conclusion:The study demonstrated that P-selectin and DCs might play an important role in renal tubulointerstitial lesions of IgA nephropathy, and DCs recruited into the renal tissues with IgA nephropathy were might mediated by P-selectin.

关 键 词：肾组织粘附分子 树突状细胞 IGA肾病 小管间质病变 

分 类 号：R692.3[医药卫生—泌尿科学]