pDCs在狼疮肾炎患者外周血和肾脏组织中的表达

Expression of plasmacytoid dendritic cells in peripheral blood and renal tissues in patients with lupus nephritis

目的研究浆细胞样树突细胞(pDCs)在狼疮肾炎患者外周血和肾脏组织的表达和分布情况,探讨pDCs在狼疮肾炎发病中的作用。方法31例狼疮肾炎患者,其中17例为活动期(14例行肾活检),14例为缓解期。分离患者外周血单个核细胞,流式细胞术检测pDCs的表达;设立正常对照组(n=12)。应用免疫荧光抗体标记及激光扫描共聚焦显微镜技术,观察14例行肾活检患者肾脏组织中pDCs的分布;设立正常对照(n=4)。结果活动期狼疮肾炎患者外周血pDCs表达的百分数为0.039±0.052,显著低于缓解期的0.168±0.174和正常对照组的0.134±0.079(均P<0.01)。正常对照肾脏组织未见pDCs浸润,而狼疮肾炎患者肾脏组织肾小球pDCs呈高水平表达,在Ⅳ型狼疮肾炎的肾脏组织中,pDCs呈局灶节段分布于系膜区。pDCs表面可见趋化因子受体CCR7表达。结论狼疮性肾炎的发生可能与其肾组织趋化因子受体水平上调,增强了外周血中pDCs向肾组织的迁移能力有关。外周血pDCs的变化可作为狼疮性肾炎治疗效果的评价指标之一。

Objective To investigate the expression and distribution of plasmacytoid dendritic cells （pDCs） in peripheral blood and renal tissues in patients with lupus nephritis, and explore the role of pDCs in the pathogenesis of lupus nephritis. Methods Among the 31 patients with lupus nephritis, 17 were in the active phase （ renal biopsy performed in 14 of them） and the other 14 in remission phase. Peripheral blood mononuclear cells were isolated, and the expression of pDCs was detected by flow cytometry. The normal control group was established （n = 12）. Immunofluorescent labeling technique and confocal laser scanning microscopy were used to detect the distribution of pDCs in renal tissues from renal biopsy, and the normal controls were established （n = 4）. Results The expression percentage of pDCs in peripheral blood in the active phase was 0. 039 ±0. 052, significantly lower than that in the remission phase（0. 168 ± 0. 174） and the normal controls （0. 134 ±0. 079） （P 〈0.01 for both）. There were almost no expression of pDCs in the normal control renal tissues, while pDCs were infiltrated in glomeruli of lupus nephritis patients, and CCR7, receptor of chemokine, was over-expressed on the surface of pDCs. Conclusion The pathogenesis of lupus nephritis may be involved with the up-regulation of chemokine receptor of renal tissues, which promotes the pDCs in peripheral blood to migrate to the renal tissues. The change of number of pDCs in peripheral blood can serve as indicators of therapeutic efficacy for lupus nephritis.