血清、尿液TWEAK对狼疮性肾炎活动性的预测及其机制分析  

Prediction of the Activity of Serum and Urine TWEAK on Lupus Nephritis and Its Mechanism

作　　者：李海英[1] LI Hai-ying(Medical Laboratory and Pathology Center,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410007)

机构地区：[1]湖南中医药大学第一附属医院医学检验与病理中心,湖南长沙410007

出　　处：《智慧健康》2018年第33期9-10,共2页Smart Healthcare

摘　　要：目的探讨血清、尿液TWEAK对狼疮性肾炎(LN)活动性的预测及其机制。方法运用ELISA法检测入选的15例正常参照者及63例LN患者血清及尿液中的单核细胞趋化因子(MCP-1)及TWEA水平,运用免疫组化法对正常参照者及LN患者肾脏组织中的TWEAK水平进行检测,研究中建立细胞迁移模型,观察并分析TWEAK对巨噬细胞迁移产生的影响。结果正常参照者中的肾脏小管上皮细胞鲜见肾小球表达,但呈现显著的TWEAK表达; LN患者中肾小管呈现显著增强,肾小球的表达明显增加,其肾内TWEAK表达水平与正常参照者相比显著上升(P<0.05),Ⅳ型的上升程度更加明显(P<0.05);狼疮性肾炎患者尿液及血清中的MCP-1及TWEAK水平均显著高于正常参照者,两组数据间对比差异性显著(P<0.05);TWEAK是诱导巨噬细胞跨膜增加的关键性因素,IV型狼疮性肾炎患者表现出弥漫性细胞增生,因此其在肾组织中TWEAK的表达最为突出。结论狼疮性肾炎活动性患者的血清、尿液及肾组织内的TWEAK均呈现明明显的表达,同时和SLEDAI、炎症因子(MCP-1)之间呈现出正相关性;因此可根据TWEA预测狼疮性肾炎活动性的临床指标,其极可能成为临床治疗狼疮性肾炎活动性的靶点。Objective To investigate the prediction of the activity of serum and urine TWEAK on lupus nephritis(LN) and its mechanism. Methods ELISA was used to detect the levels of monocyte chemoattractant(MCP-1) and TWEA in serum and urine of 15 normal reference patients and 63 LN patients. Immunohistochemistry was used to compare normal referees and LN patients. The level of TWEAK in kidney tissue was tested. A cell migration model was established in the study to observe and analyze the effect of TWEAK on macrophage migration. Results The renal tubular epithelial cells in the normal reference group showed glomerular expression, but showed significant TWEAK expression. In LN patients, the renal tubules were significantly enhanced, the expression of glomeruli was significantly increased, and the expression of TWEAK in the kidney was normal. Compared with the significant increase(P<0.05), the degree of increase of type IV was more obvious(P<0.05). The levels of MCP-1 and TWEAK in urine and serum of patients with lupus nephritis were significantly higher than those of normal subjects. The difference between the two groups was significant(P< 0.05). TWEAK was induced by transmembrane increase of macrophages. The key factor is that patients with type IV lupus nephritis show diffuse cell proliferation, so the expression of TWEAK is most prominent in renal tissues. Conclusion TWEAK in serum, urine and renal tissues of active patients with lupus nephritis is clearly expressed, and positively correlated with SLEDAI and inflammatory factor(MCP-1). Therefore, lupus can be predicted according to TWEA. The clinical indicator of nephritis activity is likely to become a target for clinical treatment of lupus nephritis.

关 键 词：狼疮性肾炎 细胞迁移 TWEAK MCP-1 

分 类 号：R593.242[医药卫生—内科学]