三条补体通路在IgA肾病血液中的活化及致病作用  

Activation and pathogenesis of three complement pathways in serum of IgA nephropathy patients

作　　者：丁冉冉[1] 邢广群[1] 王纪霞[1] 

机构地区：[1]青岛大学附属医院肾病科,青岛266000

出　　处：《中国免疫学杂志》2015年第7期947-951,共5页Chinese Journal of Immunology

基　　金：山东省自然科学基金(No.ZR2011HM079)

摘　　要：目的:研究不同的补体活化类型在Ig A肾病(Ig A nephropathy,Ig AN)中的活化及其致病作用,拓展Ig AN的发病机制理论。方法:设立Ig AN疾病组30例,疾病对照组狼疮性肾炎(Lupus nephritis,LN)患者8例作阳性对照,本院查体中心筛选健康人30例作正常对照。采用商品化的ELISA试剂盒检测Ig AN患者及对照者血清中三条补体激活渠道的标志性成分:三条补体活化通路中的共同裂解产物C3a、C5a,及溶解型终末期膜攻击复合物s C5b-9,经典途径标志物C1q,凝集素途径标志物L-ficolin(FCN2),经典途径及凝集素途径激活后的共同标志物C4d,替代途径标志物补体Bb因子。分析血清中的补体浓度与临床生化指标的相关性。结果:所有因子三组间的比较均有显著差异(P<0.05)。补体因子与临床指标间存在不同程度的相关性,其中Bb、C3a等补体裂解产物与血肌酐间呈正相关关系,FCN2与尿红细胞计数间呈负相关关系,而C1q与临床指标间无相关性。结论:Ig AN患者血液中或许存在补体经典途径、凝集素途径及替代途径的活化,并且补体激活参与临床及肾脏病理损伤,补体激活程度影响临床及病理损伤程度。Objective：To investigate the role of complement activation in the pathogenesis of Ig A nephropathy（Ig AN）. Methods： 30 patients with Ig AN as disease group,8 patients with lupus nephritis（ LN） as positive disease control group and 30 normal adults were as normal control group. Serum samples were collected. Characteristic products of the three complement pathways include split products C3 a,C5a and soluble membrane attack complex（ s C5b-9）,C1q（ complement classical pathway）,L-ficolin（ complement lectin pathway）,C4d（ both complement classical and lectin pathway） and complement factor Bb（ complement alternative pathway） were detected by commercial Elisa kits. Analysis the correlation between complement levels and the clinical items. Results： Complement activation was different among these three groups. Serum Bb,C3 a were positively correlated with the serum creatinine. FCN2 were negatively correlated with the urine red blood cell counts. Serum C1 q had no relation with the clinical items. Conclusion： Complement activation of classical pathway,lectin pathway and alternative pathway in serum might all involved in the pathogenesis of IgAN.

关 键 词：IGA肾病 补体活化 补体途径 经典 凝集素 旁路 

分 类 号：R692.6[医药卫生—泌尿科学]