原发性IgA肾病中肥大细胞浸润与肾小管间质损害的关系  

Relationship between mast cells and renal tubulointerstitial damage in patients with IgA nephropathy

作　　者：刘虹[1] 李玲艳[1] 彭佑铭[1] 刘映红[1] 成梅初[1] 袁芳[1] 许向青[1] 刘伏友[1] 

机构地区：[1]中南大学湘雅二医院肾脏病研究所、中南大学湘雅二医院肾内科、湖南省肾脏疾病与血液净化学重点实验室,长沙410011

出　　处：《肾脏病与透析肾移植杂志》2009年第5期417-422,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：湖南省自然科学基金联合基金项目(07JJ6039)

摘　　要：目的:了解肥大细胞(mast cell,MC)在人类原发性IgA肾病(IgAN)肾组织中的浸润及与肾小管间质损害程度、蛋白酶激活受体2(protease activated receptor-2 PAR-2)表达的关系,探寻肥大细胞在IgAN肾小管间质损害过程中的可能作用机制。方法:以35例IgAN肾活检石蜡包埋肾组织及5例肾肿瘤患者行肾切除的远离肿瘤部位的肾组织作为研究对象。根据Lee氏分级及Katafuchi半定量积分法分组。采用免疫组化法检测肾组织中MC和PAR-2的表达,分析它们之间及其与肾小管间质损害程度的相关性。所有数据均使用SPSS 13.0英文版统计软件进行分析。结果:(1)随着Lee氏分级等级的升高和肾小管间质损害程度的加重,MC数目和PAR-2的表达水平逐渐增加。(2)肾小管间质中MC、PAR-2的表达水平呈正相关(r=0.844,P<0.01)。肾小管间质中MC和PAR-2的表达水平均与肾小管间质病理积分呈正相关(r=0.948,0.840,P均<0.01)。结论:(1)MC浸润与原发性IgAN肾小管间质损害程度密切相关,MC可能是原发性IgAN肾小管间质损害过程的重要参与者。(2)类胰蛋白酶和PAR-2可能共同参与了原发性IgAN复杂的肾小管间质损害过程。Objective ：To investigate the correlation of mast cells infiltration and tubulointerstitial damage and also to examine the relationship between mast cells and protease activated receptor-2 （PAR-2） expression in patients with IgA nephropathy. Methodology：Renal biopsy specimens from thirty five patients with a clinicopatholagieal diagnosis of IgA nephropathy and normal renal tissue sections from 5 nephrectomized patients for nephroma were collected. The changes of pathomorphological types were according to Lee SM and Katafuchi semiquantitative scoring system. The expression of tryptase and PAR-2 was detected with immunohistochemistry. The possible correlation among the expression level of tryptase, PAR-2 and histopathological score was evaluated. All data has been analyzed by SPSS 13.0. Results： The percentages of mast cells and the expressions of PAR-2 were increased with the aggravation of tubuliointerstitial damage and the elevation of Lee grading in paitents with IgA nephropathy. The percentage of mast cell amounts was positively correlated with the expressions level of PAR-2 （r = 0. 844, P 〈 0. 01 ）. In addition to, there was a significant positive correlations among the score of renal tubule histopathology, the infiltration of mast cell, and the expression level of PAR-2. Conclusion：The positive correlation between the percentages of infiltrating mast cells and tubulointerstitial damage suggested that the mast cells be probaly invovled in the development of the tubulointerstitial damage, and that the mast cell- derived tryptase and PAR-2 be also probably contributed to the tubulointerstitial damage in patients with IgA nephropathy.

关 键 词：肥大细胞 蛋白酶激活受体2 IGA肾病 肾小管间质损害 

分 类 号：R692.3[医药卫生—泌尿科学]