纤溶酶原激活物及其抑制剂-1表达与IgA肾病毛细血管密度相关关系的研究  

Correlation of plasminogen activator and plasminogen active inhibitor expression and capillary density in IgA nephropathy.

作　　者：邱强[1] 孙雪峰[1] 陈香美[1] 洪权[1] 

机构地区：[1]解放军总医院全军肾脏病研究所暨肾病重点实验室,北京100853

出　　处：《中国实用内科杂志》2008年第5期343-346,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金面上项目(30470803);国家基础研究发展规划项目(2007CB507400)

摘　　要：目的应用激光微切割和定量PCR技术检测IgA肾病纤溶酶原激活物(PA)和纤溶酶原激活物抑制剂-1(PAI-1)的表达及其在IgA肾病毛细血管病变中的作用。方法对2003—2004年全军肾脏病研究所收治的24例IgA肾病患者采用激光微切割方法分离肾组织切片(8μm)中的肾小球(20个/例)和肾小管及其周围间质(200个/例),提取RNA反转录后,进行TaqMan实时定量PCR检测肾小球及肾小管间质内PA及PAI-1的mRNA表达。同时,对肾组织切片进行免疫组织化学染色,采用计算机图像分析系统定量分析毛细血管密度。结果随着病变的加重,IgA肾病肾小球毛细血管袢密度、肾小管周围毛细血管密度均随之减小;IgA肾病患者的肾小球毛细血管袢密度及肾小管周围毛细血管密度均与血清肌酐成负相关,R2分别为0.6946和0.6271(P均<0.05)。肾小球tPA mRNA/PAI-1 mRNA比值与肾小球毛细血管袢密度呈正相关(R2=0.7094,P<0.01);肾小管间质uPA mRNA/PAI-1 mRNA比值与肾小管周围毛细血管密度呈正相关(R2=0.6668,P<0.01)。结论肾小球和肾间质毛细血管密度的下降可能与IgA肾病的进展有关。肾小球局部tPA与PAI-1 mRNA表达失衡及肾小管间质中uPA与PAI-1 mRNA表达失衡可能是导致肾小球和肾小管周围毛细血管密度降低的原因。Objective To analyze mRNA and protein expressions of plasminogen activator and plasminogen activator inhibitor-1 using microdissection and quantitative real-time PCR,and to analyse their associations with microvascular diseases in IgA nephropathy. Methods Twenty-four IgA nephropathy patients treated in Kidney Center and Kidney Laboratory of PLA from 2000 to 2004 were admitted into the study ;20 renal glomeruli or 200 renal tubules and peritubular interstitial per patient were captured by Laser Microdissection System from IgA nephropathy renal biopsy slides（ 8 μm） ,and mRNA was extracted. PA mRNA and PAI-1 mRNA levels in glomerulus and tubulointerstitial area were measured by Taqman quantitative real-time PCR. Capillaries densities in glomerulus and tubulointerstitial area were measured using immunohis- tological staining method and computer image analysis system. Results With the aggravation of lesions, the glomeruli and peritubular capillaries densities of IgA nephropathy decreased. The glomerular and peritubular capillaries densities were negatively associated with the level of serum creatinine （ R^2 = 0. 6946 and R^2 = 0. 6271, P 〈 0. 01, respectively ）. Glomerular tPA mRNA/PAI-lmRNA radio was positively associated with glomerular capillaries densities （R2 = 0. 7094, P 〈 0. 01 ） ;tubulointerstitial uPA mRNA/PAI-1 mRNA radio was positively associated with tubulointerstitial capillaries densities （ R^2 = 0. 6668,P 〈 0. 01 ）. Conclusion The decrease of glomerular and tubulointerstitial capillaries densities is possibly related to the progress of IgA nephropathy. It is the expression disequilibrium of tPA and PAI-1 mRNA in local glu- merular as well as uPA and PAI-1 mRNA in tubulointerstitial that possibly results in the decrease of capillaries densitiesin glomeruli and peritubules.

关 键 词：IGA肾病 毛细血管病变 纤溶酶原激活物 纤溶酶原激活物抑制剂-1 

分 类 号：R5[医药卫生—内科学]