紫癜性肾炎患儿肾组织和尿液Podocalyxin蛋白表达与足细胞损伤的关系  

Study on the expression of podocalyxin in Henoch-Schonlein purpura nephritis

作　　者：彭晓杰[1] 郑卫民[1] 傅睿[1] 黄玉辉[1] 邓美慧 吴小川 陶珊珊 PENG Xiaojie;ZHENG Weimin;FU Rui(Department of Nephrology,Jiangxi provincial Children’s Hospital,Nanchang 330006,China)

机构地区：[1]江西省儿童医院肾脏科,南昌330006

出　　处：《江西医药》2020年第9期1167-1172,1176,共7页Jiangxi Medical Journal

基　　金：江西省卫生健康委员会科技计划项目,编号20175499。

摘　　要：目的研究足细胞蛋白Podocalyxin在紫癜性肾炎各病理分型肾组织中表达变化,同时检测尿中足细胞以期反映肾脏病理改变。方法应用免疫荧光方法检测Podocalyxin在4例正常肾组织及56例紫癜性肾炎进行抗过敏﹑激素或免疫抑制剂等治疗前各病理分型(Ⅱa﹑Ⅱb﹑Ⅲa﹑Ⅲb﹑Ⅳa﹑Ⅳb﹑Ⅴa﹑Ⅴb)肾组织中的表达,并对其结果进行定量分析;同时检测8例健康儿童及56例HSPN患儿尿中足细胞Podocalyxin的阳性发生率。结果足细胞蛋白Podocalyxin在正常对照组﹑HSPNⅡa及Ⅱb组肾组织阳性荧光信号表达沿肾小球毛细血管壁走行分布均匀、连续,各组肾组织Podocalyxin染色占肾小球面积的百分比和灰度值组间无统计学差异(P>0.05),而在HSPNⅢa﹑Ⅲb﹑Ⅳa﹑Ⅳb﹑Ⅴa及Ⅴb组肾组织阳性荧光信号表达均有不同程度分布不均匀,或呈颗粒状分布,或节段性消失,在新月体形成区或硬化区几乎无阳性信号表达,从Ⅱb﹑Ⅲa﹑Ⅲb﹑Ⅳa﹑Ⅳb﹑Ⅴa到Ⅴb其表达依次下降,各组间比较有显著差异(P<0.01);病理分型Ⅲ型以上HSPN检测尿中有足细胞蛋白Podocalyxin的表达阳性。结论随着HSPN病理改变的加重,足细胞蛋白Podocalyxin在肾组织的表达呈下降趋势,Ⅲ型以上HSPN患儿尿足细胞蛋白Podocalyxin检测阳性,提示足细胞损伤可能在HSPN病理进展中发挥一定作用。Objective To study the expression of Podocalyxin in renal pathological grades of Henoch-Schonleln purpura nephritis(HSPN),and explore the role of the Podocalyxin expression in kidney and injury of podocyte during the progressive course of HSPN.Methods The expression of Podocalyxin in 4 normal controls and 56 pathological grades of HSPN(Ⅱa,Ⅱb,Ⅲa,Ⅲb,Ⅳa,Ⅳb,Ⅴa andⅤb)before treatment in kidney were detected by immunofluorescence staining and quantitatively analyzed by the image analysis system.In the meantime,the expression of podocyte Podocalyxin in 8 normal controls and 56 pathological grades of HSPN in urine were detected too.Results The expression of Podocalyxin of normal control,HSPNⅡa andⅡb was linear and continuous along glomerular capillary loops in kidney,and no significant difference of the percent and the level of the immunofluorescence staining area between them(P>0.05)and the expression of Podocalyxin of HSPN Ⅲa,Ⅲb,Ⅳa,Ⅳb,Ⅴa and Ⅴb was linear and granular along glomerular capillary loops partially in kidney,while no expression was detected in the crescentic or sclerotic areas.The image analysis showed a gradual decrease in the expression intensity of Podocalyxin from grade HSPN Ⅱb toⅤb in the kidney(P<0.01).Podocyte marked by anti-podocalyxin antibody was found in urine from grade HSPNⅢto V.Conclusion The expression change of Podocalyxin in kidney decreased gradually from grade HSPN Ⅱb to Ⅴb,and the podocyte Podocalyxin detected in urine from grade HSPN Ⅲ to Ⅴ,which might play an important role during the progressive course of HSPN.

关 键 词：Podocalyxin(PCX) 足细胞 紫癜性肾炎 

分 类 号：R726.9[医药卫生—儿科]