WISP-1在IgA肾病患者中的表达与肾间质纤维化的关系  

The association of WISP- 1 expression in IgA nephropathy patients with renal interstitial fibrosis

作　　者：钟翔 彭婷 涂月菊 李贵森[1] 王莉[1] 

机构地区：[1]电子科技大学附属医院四川省人民医院肾脏内科暨肾脏病研究所,成都610072 [2]重庆市南川区人民医院肾脏科,408400

出　　处：《中华肾脏病杂志》2017年第9期649-655,共7页Chinese Journal of Nephrology

基　　金：基金项目：国家自然科学基金（81300618）;四川省卫计委基金（17PJ058）;四川省人民医院基金（2016L707）

摘　　要：目的初步探讨IgA肾病（IgAN）患者血清与肾组织中Wntl诱导分泌蛋白1（Wnt induced secreted protein-1，WISP-1）的表达与肾间质纤维化的关系。方法收集肾活检明确诊断有肾间质纤维化的局灶增生型IgA。肾病53例，以16例微小病变型肾病（MCD）为阴性对照组，14例健康志愿者为正常对照组。应用免疫组化和酶联免疫吸附法分别测定研究对象。肾组织和血清中WISP-1水平，同时测定相关的临床指标，并对患者肾脏纤维化程度进行统计，分析血清WISP-1的表达与患者临床及病理的特点，明确其在IgAN肾间质纤维化中的意义。结果免疫组化结果显示，WISP-1在MCD患者和正常对照者肾脏组织中均无明显表达，而在有肾间质纤维化的局灶增生型IgAN患者的肾组织中有大量沉积，主要表达在肾间质；且IgAN患者的血清WISP-1水平显著高于正常对照（P=0．015）和MCD患者（P=0．030）。在IgAN肾间质纤维化程度的亚组分析中，肾间质纤维化评分0～10％（F1组）和纤维化评分〉25％（F3组）两组的WISP-1血清浓度显著高于正常对照组和MCD组（均P〈0．05），而F2组（10％〈纤维化≤25％）与正常对照组和MCD组之间差异则无统计学意义（P〉0．05）。结论WISP-1在肾间质纤维化的IgAN患者血清和肾组织中的表达水平一致，均高于未发生肾纤维化的正常对照和MCD患者，且IgAN患者血清WISP-1的表达在纤维化评分较低组明显升高。血清和肾脏组织中WISP一1的表达与IgAN肾间质纤维化发生有关，WISP-1可能作为一个早期的驱动因子在IgAN。肾间质纤维化中发挥重要作用。Objective To investigate the relationship between the expression of Wnt induced secreted protein- 1 （WISP- 1） and the fibrosis of renal biopsy tissue in IgA nephropathy （IgAN） patients. Methods Fifty-three patients firstly diagnosed as IgA nephropathy by renal biopsy were included and classified according to Oxford and Lee＇s classification. Sixteen patients with MCD entered the fibrosis negative control group, and fourteen healthy adults entered the normal control group. The expression of WISP- 1 in renal tissues and serum of all subjects were detected by immunohistochemistry and ELISA respectively. Results Immunohistochemistry results showed that WISP-1 was not expressed in MCD patients and normal human kidney tissues, which was abundantly deposited in renal tissue of patients with focal proliferative IgAN with renal interstitial fibrosis. The serum level of WISP- 1 in IgAN patients was significantly higher than that in normal subjects （P=0.015） and MCD patients （P=0.030）. In the subgroup analysis of IgAN renal fibrosis, the serum concentration of WISP- 1 of fibrosis grade between 0-10% （F1 group） and fibrosis 〉 25% （F3 group） were significantly higher than that in the normal group and the MCD group （all P 〈 0.05）. There was no significant difference between F2 group （10% 〈 fibrosis≤25%） and normal group or MCD group （P 〉 0.05）. Conclusions The expression of WISP- 1 in serum and renal tissue of renal interstitial fibrosis IgAN patients is higher than that of normal and MCD patients without renal fibrosis, and the IgAN patients＂ serum level of WISP- 1 is significantly increased in fibrosis lower score group. The expressions of WISP- 1 in serum and renal tissue are related to the occurrence of IgAN renal interstitial fibrosis, in which WISP- 1 may play an important role as an early precursor factor in the pathogenesis of IgAN renal interstitial fibrosis.

关 键 词：肾小球肾炎 IGA 纤维化 Wnt1诱导分泌蛋白-1 微小病变型肾病 

分 类 号：R692.31[医药卫生—泌尿科学]