系膜增生性肾炎肾组织E2F-1的表达及临床意义

Expression and clinical significance of E2F-1 in renal tissue in mesangial proliferative glomerulonephritis

目的:探讨核转录因子-1(E2F-1)在系膜增生性肾炎(MsPGN)肾组织中的表达及其与肾固有细胞增生和临床的关系。方法:采用免疫组织化学法检测36例MsPGN患者(MsPGN组)肾活检组织E2F-1的表达,并将其与临床作相关性分析。肾外伤切除的正常肾组织6例作为正常对照组。结果:正常对照组肾小球未见E2F-1表达,肾小管间质见少许表达。MsPGN组肾小球和肾小管间质均有E2F-1表达,两组比较,具有显著统计学差异(P<0.01),轻、中、重度系膜增生组随系膜增生加剧E2F-1表达逐渐增强(P<0.05或P<0.01)。肾小球、肾小管间质E2F-1表达与未使用类固醇激素/免疫抑制剂、未使用血管紧张素转移酶抑制剂(ACEI)/血管紧张素受体拮抗剂(ARB)呈正相关;肾小球E2F-1表达与BP、24h尿蛋白(TMP)水平呈正相关,与内生肌酐清除率(Ccr)呈负相关;肾小管间质E2F-1表达与临床无相关性。肾小球与肾小管间质E2F-1表达无相关性。结论:E2F-1表达水平可反映MsPGN患者系膜细胞及小管间质的增生程度,也可间接反映BP、TMP及肾功能水平,药物可干预E2F-1的表达。

Objective To investigate the expression of nuclear transcription factor E2F-1 in renal tissue of patients with mesangial proliferative glomerulonephritis （MsPGN） and explore its clinical significance. Methods Paraffin-embedded renal biopsy renal tissue sections from 36 patients with MsPGN were detected by immunohistochemical staining with anti-E2F-1 monoclone antibody. Normal renal tissue sections from 6 nephrectomized patients with trauma were used as controls. Possible correlation between E2F-1 positive area and cell proliferation, clinic data were evaluated. Results There was no obvious E2F-1 expression in normal glomeruli and a little expression in renal tubular-interstitial, while, significantly higher expressions were detected in both glomeruli and tubular-interstitial in MsPGN group（P 〈 0.01 ）. the more severity of mesangial proliferation, the more E2F-1 expressions in glomeruli and renal tubular-interstitial gradually enhanced with mesangial proliferation enhanced in mild. Moderate and severe groups respectively （P 〈 0.05 or P 〈 0.01 ）. E2F-1 expression in glomeruli and renal tubular-interstitial showed a positive correlation with no using glucocorticoid/immuoinhibitors or angiotensin-converting enzyme inhibitor （ACEI） / angiotensin receptor blocker （ARB）, E2F-1 expression in glomeruli was positive correlated with blood pressure and 24- hours proteinuria（TMP） as well,while negative correlated with endogenous creatinine clearance rate in glomeruli. E2F-1 expression in renal tubular-interstitial was not related with clinical outcome. There was no correlation of E2F-I expression between glomeruli and renal tubular-interstitial. Conclusions E2F-1 expression demonstrates the degree of mesangial cell and renal tubular-interstitial proliferation in MsPGN. It reflects indirectively blood pressure, TMP and kidney function, e2F-1 expression is possibly intervented by some drugs.