温阳活血利水方对阿霉素肾病大鼠肾脏足细胞CD_2 AP、synatopodin、α-actinin-4表达的影响  

Effect of Formula of Warming Yang,Promoting Blood Circulation and Diuresis on Expression of CD_2 AP,Synatopodin and α-actinin-4 in Rat with Ariamycin-Induced Nephropathy

作　　者：袁军[1,2] 杨柳[1,3] 肖浪[1] 王安峰[1] 鲁艳芳[1] 

机构地区：[1]湖北中医药大学临床医学院,武汉430061 [2]湖北省中医院肾内科,武汉430061 [3]湖北中医药大学,硕士研究生2012级武汉430061

出　　处：《光明中医》2013年第10期2041-2045,共5页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：教育部博士点新教师项目(No:20124230120003);湖北省卫生厅基金项目(No:QJX2010-37)

摘　　要：目的观察温阳活血利水法治疗对足细胞CD2AP、synatopodin、α-actinin-4表达的影响,以探讨其疗效的作用机制。方法用阿霉素(ADR)诱导一种类似人类微小病变肾病模型,1周后分别用温阳活血方和强的松治疗,持续4周,并设空白对照组(正常组)、病理对照组(造模组)。观察实验大鼠的一般情况;检测大鼠24小时尿蛋白定量;检测总蛋白、白蛋白、总胆固醇、三酰甘油的水平;采用免疫荧光染色测定大鼠肾小球CD2AP、synatopodin、α-actinin-4表达;光学显微镜观察肾组织形态学变化;电镜下观察足细胞足突的变化。结果模型组24小时尿蛋白定量明显升高(P<0.01),血清总蛋白、白蛋白明显降低(P<0.01),血清脂质水平升高(P<0.01),CD2AP、synatopodin蛋白表达明显减少,α-actinin-4表达分布不均匀,足突融合明显。两个治疗组均能降低24小时尿蛋白定量,升高血清总蛋白、白蛋白水平(P<0.01)。温阳活血利水方能降低血清脂质水平(P<0.01)。两个治疗组均能改善肾组织中CD2AP、synatopodin蛋白的表达减少,改善α-actinin-4表达分布异常,改善其肾组织的病理改变。结论温阳活血利水法能使阿霉素肾病综合征大鼠CD2AP、Synaptopodin表达下降及α-actinin-4分布异常,从而有助于稳定actin骨架,改善足细胞融合,减少蛋白尿。Objective The purpose of this study was to investigate the curative effects of method of warming yang-promoting blood circulationdiuress in treating minimal change nephropathy model,and explore the protective mechanisms of method of warming yang to promote blood circulation and diuress. Methods The minimal change nephropathy model was induced by injection of adriamycin into the tail vein. After 1 week, rats were randomly divided into model group, Chinese herb group and prednisone group. Level of total protein （TP） , albumin （ALB） , cholesterol and triglyceride in blood were measured. The distribution and protein expression of CD2AP, synatopodin and α-actinin- 4 were measured by immunofluorescence. Besides, Glomerular morphology was observed by light microscopy, and the influence of treatments on podocytes was examined in renal tissues by electron microscopy after the rats were sacrificed for 28 days treatment. Results In model group, 24-hour urinary protein, plasma cholesterol and triglyceride were significantly increased, and TP and ALB were decreased. The fusion and effacement of foot processes were observed, and the expression of CD2AP and synatopodin in model group significantly decreased. The abnormal distribution of α-actinin-4 was observed. The treated groups markedly increased TP and ALB level and decreased 24h urinary albumin. Plasma cholesterol and triglyceride were significantly reduced in the Chinese herb group. Treatment with prednisone or Chinese herb both partially reduced the expression of CD2AP and synatopodin and ameliorated the abnormal distribution of α-actinin-4 and podocyte foot process effacement. Conclusion The method of warming yang-promoting blood circulation-diuress attenuated the decreased expression of CD2AP, synatopodin and the abnormal distribution of α-aetinin-4 in minimal change nephropathy model which was closely related with the reduction of proteinuria.

关 键 词：水肿 温阳活血利水法 阿霉素 微小病变型 肾病综合征 足细胞 

分 类 号：R277.5[医药卫生—中医学]