IgA肾病系膜细胞-足细胞轴在肾小管间质病变中的作用  

Role of mesangial cells and podocyte axis in the renal tubulointerstitial lesions of IgA nephropathy

作　　者：高原[1] 杨林[1] 王建荣[1] 杨万霞[1] 张丽萍[1] 

机构地区：[1]河北医科大学第二医院肾内科,石家庄050000

出　　处：《临床与实验病理学杂志》2018年第1期73-76,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨IgA肾病系膜细胞-足细胞轴在肾小管间质病变中的作用。方法收集40例经肾穿刺活检明确诊断的IgA肾病,采用免疫组化法检测足细胞表面特异性标志物WT-1、肾组织TNF-α、IL-6的表达;采用酶联免疫吸附法测定患者尿TNF-α、IL-6的活性水平。结果 IgA肾病患者肾小球系膜增生评分与WT-1的表达呈负相关(r=-0.763,P<0.05),与肾组织TNF-α及IL-6表达、尿液TNF-α及IL-6活性水平均呈正相关(r=0.674、r=0.853、r=0.819、r=0.763,P均<0.05),IgA肾病患者随肾小管间质病变加重,肾组织WT-1的表达逐渐降低;而TNF-α、IL-6的表达逐渐升高,且尿液TNF-α、IL-6的活性水平逐渐升高(P<0.05)。肾组织WT-1表达与肾组织IL-6、TNF-α表达及尿液IL-6、TNF-α活性水平均呈负相关(r=-0.603、r=-0.564、r=-0.563、r=-0.544,P均<0.05),与尿渗透压呈正相关(r=0.821,P<0.05),且与肾小管间质损害程度分级呈正相关(r=0.793,P<0.01)。结论 IgA肾病系膜细胞增殖产生的细胞因子作用于足细胞并诱导足细胞凋亡、加重肾小管间质损伤。Purpose To investigate the role of mesangial cells and podocyte axis in the renal tubulointerstitial lesion in IgA nephropathy. Method Forty cases of IgA nephropathy diagnosed by renal biopsy were analyzed. The expression of WT-1, a specific marker of podocyte surface, TNF-α and IL-6 in renal tissue was observed by irnmunohistochemistry, and the activity of TNF-α and IL-6 in urine was detected by enzyme-linked immunosorbent assay （ELISA）. Results The glomerular mesangial proliferation score was negatively correlated with the expression of WT-1 in IgA nephropathy （r = - 0. 763, P 〈 0. 05）, and positively correlated with the expression of renal tissue TNF-α and IL-6, urine TNF-α and IL-6 activity levels in IgA nephropathy （r =0.674, r =0.853, r =0.819, r =0.763, all P〈 0. 05 ）. With the aggravation of renal tubulointerstitial lesions in IgA nephropathy, the expression of WT-1 decreased gradually,while the expression of TNF-α and IL-6 in renal tissue increased gradually, and the activity of TNF-α and IL-6 in urine increased gradually （ P 〈 0. 05 ）. The expression of WT-1 was negatively correlated with renal tissue IL-6 expression, TNF-α expression, urine IL-6 activity level, and urine TNF-α activity level （r = - 0.603, r = -0.564, r = -0.563, r = -0.544, all P 〈 0. 05）, and it was positively correlated with the urine osmotic pressure （r = 0. 821, P 〈 0. 05 ） and positively correlated with the degree of renal tubular interstitial damage （ r = 0. 793, P 〈 0. 01 ）. Conclusion The cytokines produced by mesangial cell proliferation of IgA nephropathy play a role in podocyte and induce podocyte apoptosis and aggravate tubulointerstitial injury.

关 键 词：IGA肾病 系膜细胞-足细胞轴 细胞因子 肾小管间质损伤 

分 类 号：R692[医药卫生—泌尿科学]