尿可溶性CD163在慢性移植肾肾损伤中的作用  

Role of urinary soluble CD163 in chronic kidney allograft injury

作　　者：杨迷玲[1] 徐宪伟 张果[1] 曲青山[2] 杨金花[1] YANG Miling;XU Xianwei;ZHANG Guo;QU Qingshan;YANG Jinhua(Department of pathology,Zhengzhou People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院病理科,郑州450003 [2]郑州人民医院器官移植科,郑州450003

出　　处：《实用医学杂志》2018年第22期3731-3735,共5页The Journal of Practical Medicine

基　　金：郑州市科技攻关计划项目(编号:20150078)

摘　　要：目的探讨尿可溶性CD163(sCD163)在慢性移植肾肾损伤中的作用。方法选取诊断为慢性移植肾肾损伤的肾活检标本30例和正常肾组织10例做对照,同时收集尿液标本;用双抗体夹心酶联免疫法即ELISA法定量检测尿液可溶性CDl63水平;用Masson染色法评估肾活检组织的间质纤维化程度;用免疫组织化学法检测肾活检组织中CD163(标记M2型巨噬细胞)和SMA蛋白的表达情况;分析患者尿可溶性CD163水平与患者血肌酐(Cr)、活检组织中CD163和移植肾间质纤维化程度的关系。结果慢性移植肾肾损伤患者尿可溶性CD163水平显著高于正常人(P <0.05);移植肾组织中的CD163和SMA显著高于正常肾组织(P <0.05);随着移植肾间质纤维化程度的加重,尿可溶性CD163水平和肾组织中CD163的表达逐渐增多,患者血肌酐和尿素氮水平也逐渐升高(P <0.05);患者尿可溶性CD163水平与移植肾组织中CD163的表达和血肌酐水平呈正相关(P <0.001)。结论 CD163+的M2型巨噬细胞可以促进慢性移植肾肾损伤的发生、发展,导致肾间质纤维化,引起患者肾功能不全,尿可溶性CD163可以作为慢性移植肾肾损伤的生物标志物。Objective To investigate the role of urinary soluble CD163 in chronic kidney allograft injury.Methods Determination of soluble CDl63 in urine by double antibody sandwich enzyme-linked immunosorbent assay was performed.The degree of interstitial fibrosis in renal biopsy tissues was assessed by Masson staining.By using immunohistochemical staining method,the levels of CD163 and SMA expression were detected in the renal biopsy tissues of 30 cases of chronic allograft injury(CAI)and 10 cases of normal kidney.Results The levels of urinary soluble CD163 in patients with CAI were significantly higher than those in normal controls(P<0.05).There were statistically significant differences in expression of CD163 and SMA between kidney allograft and normal kid-ney tissue(P<0.05).With the increase of renal fibrosis severity,and the level and expression of urinary soluble CD163,the levels of serum Cr and BUN were increased(P<0.05).The level of soluble CD163 in urine was positively correlated with the expression of CD163 and serum creatinine(P<0.001).Conclusion The findings identify a major population of M2-type macrophages in patients with chronic kidney injury,and suggest that these M2-type macrophages might promote the development of interstitial fibrosis in IF/TA-NOS and lead to renal insuffi-ciency in patients.Urinary soluble CD163 may serve as a bio-marker of chronic kidney allograft injury.

关 键 词：肾移植 尿可溶性CD163 M2型巨噬细胞 间质纤维化 

分 类 号：R692[医药卫生—泌尿科学]