人类肾小球肾炎中肾小管及间质细胞表型转化的研究  

Phenotypic changes of renal tubulointerstitial cells in human glomerulonephritis

作　　者：王玉[1] 李晓玫[1] 邹万忠[1] 王海燕[1] 

机构地区：[1]北京医科大学第一医院肾内科,北京医科大学肾脏病研究所100034

出　　处：《中华肾脏病杂志》2000年第1期7-10,共4页Chinese Journal of Nephrology

基　　金：教育部跨世纪优秀人才基金![科技函(1992)2号]

摘　　要：目的观察人类肾小球肾炎时肾小管-间质细胞发生的表型转化现象。方法对３４例肾小球肾炎患者肾穿刺标本进行免疫组织化学染色，观察。平滑肌肌动蛋白（α－ＳＭＡ）、波形蛋白（ｖｉｍｅｎｔｉｎ，Ｖｉｍ）、角蛋白（ｃｙｔｏｋｅｒａｔｉｎ，ＣＫ）、增殖细胞核抗原（ＰＣＮＡ）及Ⅳ型胶原（ＣｏｌｉⅣ）表达，并进行透射电镜观察。结果在人类肾小球肾炎中，肾小管上皮细胞可出现间质细胞标志物波形蛋白及α－ＳＭＡ表达，并可游离至肾间质中；肾间质中 α－ＳＭＡ阳性的肌纤维母细胞（ｍｙｏｆｉｂｒｏｂｌａｓｔ， Ｍｙｏ－ＦＢ）增多，与波形蛋白阳性的间质细胞分布区域近似，并伴有Ⅳ型胶原的聚积增多。α－ＳＭＡ阳性的肾小管－间质细胞均有增殖现象。结论人类肾小球肾炎时，肾小管上皮细胞和间质成纤维细胞可发生向肾间质肌纤维母细胞的表型转化，参与肾间质纤维化的发展。Objective To observe the phenotypic changes of renal tubulo-interstitial cells in human glomerulonephritis. Methods Immunohistochemical studies were performed on 34 specimen from renal biopsy to detect the phenotypic markers including α-smooth muscle actin(α-SMA). vimentin, and cytokeratin (AE1/AE3 ). Proliferating nuclear antigen (PCNA ). collagen Ⅳ expression and pathological changes in renal tubular interstitium were also assessed. Micropathological changes were observed by electromicroscopy. Results Both vimentin and α-SMA were positive in some of renal tubules. Electromicroscope examination proved that there was indeed epithelial cells invaded into tile interstitium. There was accumulation of α-SMA positive cells in interstitium accompanied with increased deposition of collagen Ⅳ. Consecutive staining showed that the distribution of α-SMA positive cells was almost the same area as that of vimentin positive cells. Double staining showed some of these α-SMA positive cells were proliferating both in renal tubule and interstitium. Conclusion Both renal interstitial and tubular cells may undergo phenotypic change turned to become myofibroblast with the newly appeared expression of α-SMA, and the accumulation of myofibroblasts correlates with the interstitial fibrosis.

关 键 词：肾小管 管间质 表型 肌纤维母细胞 肾小球肾炎 

分 类 号：R692.31[医药卫生—泌尿科学]