特发性膜性肾病肾组织中NLRP3炎性小体的表达及意义  

Expression and significance of NLRP3 inflammasome-related factors in renal tissue of idiopathic membranous nephropathy

作　　者：李巍 潘艳[1] 倪文静 万璐 钱宇池 高佩茹 陈卫东 LI Wei;PAN Yan;NI Wenjing;WAN Lu;QIAN Yuchi;GAO Peiru;CHEN Weidong(Department of Nephrology,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,Anhui,China)

机构地区：[1]蚌埠医学院第一附属医院肾病科,安徽蚌埠233000

出　　处：《西部医学》2025年第4期505-510,共6页Medical Journal of West China

基　　金：安徽省重点研究与开发计划项目(202004j07020011)。

摘　　要：目的通过观察特发性膜性肾病(IMN)患者肾组织中核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、凋亡相关斑点样蛋白(ASC)、含半胱氨酸的天冬氨酸蛋白水解酶-1(Caspase-1)、焦亡关键蛋白(GSDMD)的表达水平,探讨NLRP3炎性小体相关因子在IMN发生、发展中的意义。方法选取我院2020年6月—2022年12月经肾活检病理初次确诊为IMN的患者59例为IMN组,同期选取因输尿管肿瘤、肾肿瘤或肾挫伤等行肾脏切除部分健康肾组织的患者20例为NC组。收集IMN组与NC组中一般临床资料及生化相关指标,比较两组间差异;采用免疫组化方法检测肾组织中NLRP3、ASC、Caspase-1、GSDMD、IL-1β和IL-18表达,测光密度值比较两组间差异。并将IMN组分为纤维化组34例和无纤维化组25例,比较两组间NLRP3、ASC、Caspase-1、GSDMD、IL-1β、IL-18的差异,并观察NLRP3炎性小体与肾组织纤维化关系;用Pearson相关性分析NLRP3炎性小体相关因子与临床指标之间的相关性。结果IMN组肾组织中NLRP3、ASC、Caspase-1、GSDMD、IL-1β和IL-18的表达明显高于NC组(P<0.05);IMN纤维化组NLRP3、ASC、Caspase-1、GSDMD、IL-1β和IL-18的表达强于无纤维化组(P<0.05);相关性结果显示,IMN患者肾组织中NLRP3、ASC、Caspase-1、GSDMD、IL-1β和IL-18的表达与ALB水平呈负相关(P<0.05),与24h-Upro、TC、TG水平呈正相关性(P<0.05),与HB、Scr、BUN、Cys-C、UA、eGFR水平均无相关(P>0.05)。结论NLRP3炎性小体相关因子在IMN肾组织中表达水平明显增加,并且各因子之间相互影响,引发肾组织损伤及纤维化,参与IMN的发生、发展。Objective To investigate the clinical significance of NLRP 3 inflammasome-related factors in the occurrence and development of IMN by observing the expression levels of NLRP 3 inflammasome-related factor NLR family Pyrin domain protein 3(NLRP 3),apoptosis-related spot-like protein(ASC),aspartate proteollase-1(Caspase-1),and pyroptosis critical protein(GSDMD)in renal tissue of idiopathic membranous nephropathy(IMN).Methods In this study,59 patients,initially diagnosed with IMN in The First Affiliated Hospital of Bengbu Medical College from June 2020 to December 2022,were selected as the IMN group(IMN group).During the same period,20 patients who underwent some healthy renal tissue resection due to ureteral tumor,renal tumor or renal contusion were selected for the normal control group(NC group).General clinical data and biochemical related indicators were collected in the IMN and NC groups.The expression of NLRP 3,ASC,caspase-1,GSDMD,IL-1βand IL-18 factors in kidney tissue were observed.Pearson correlation between NLRP 3 inflammasome related factors and its correlation with clinical indicators,and divided the IMN group into 34 patients in fibrosis group and 25 patients without fibrosis group,we observed the relationship between NLRP 3 inflammasome and renal tissue fibrosis.Results In the comparison of the expression of NLRP 3,ASC,caspase-1,GSDMD,IL-1β,and IL-18 factors,IMN group was significantly higher than NC group(P<0.05);The IMN fibrosis group was stronger than the group without fibrosis(P<0.05).The expression of NLRP 3,ASC,caspase-1,GSDMD,IL-1βand IL-18 factors was negatively correlated with their ALB levels in the renal tissue of IMN patients(P<0.05);a positive correlation with the 24h-Upro level,TC level and TG(P<0.05).There was no correlation with HB,Scr,BUN,Cys-C,UA,or eGFR levels(P>0.05).Conclusion The expression level of NLRP 3 inflammasome-related factors increases significantly in IMN renal tissue,and the factors influence each other,causing renal tissue injury and fibrosis,and participate in the o

关 键 词：特发性膜性肾病 ASC/Caspase-1/GSDMD NLRP3炎性小体 

分 类 号：R692[医药卫生—泌尿科学]