摘要
Objective To investigate the pattern of monocyte chemoattractant prolein-1 (MCP-1) distribution in the renal interstitium and evaluate its pathogenic role in tubulo-interstitial lesions in patients with lupus nephritis, the distribution of MCP-1 in renal tissue was observed.Methods Eighteen female patients with biopsy-proven lupus nephritis were enrolled in this study. No intensive immunosuppresive therapy was used in these patients during the 3 months prior to renal biopsy. The distribution of MCP-1, infiltration of CD68+ (macrophage/monocyte), CD4+ and CD8+ cells in the tubulo-interstitium of patients with lupus nephritis was detected using immunohistochemical staining with specific antibodies. Renal specimens from patients with minimal change glomerulonephritis were used as controls. Results MCP-1 protein was widely distributed in the renal tissue of patients with lupus nephritis, mainly located at the baso-lateral surface of tubular epithelial cells (16/18 biopsies), and on the wall of interstitial blood vessels (9/18 biopsies). In contrast, tubular MCP-1 staining was weak and rare in renal tissue from controls (7.4±6.2% vs 26.7±22.8%, P<0.01). Tubulo-interstitial infiltration of CD68+, CD4+ and CD8+ cells was markedly increased in patients with lupus nephritis as compared to controls. The tubular expression of MCP-1 was strongly associated with the amount of CD68+ cell infiltration in the interstitium (r=0.5420, P<0.05) and the extent of interstitial fibrosis. There was no correlation between MCP-1 production in tubules and the degree of urinary protein excretion in patients with lupus nephritis (r=0.0547, P>0.05).Conclusions The expression of MCP-1 in the renal tubules and vascular wall was markedly increased in patients with lupus nephritis. The overproduction of MCP-1 in renal tissue may contribute to monocyte recruitment in the interstitium and thus result in tubulo-interstitial damage in lupus nephritis.
目的 观察狼疮性肾炎 (LN)患者肾组织中单核细胞趋化因子 (MCP 1)的分布及其与肾间质单核细胞浸润和间质病变的关系 ,探讨其在LN患者肾小管间质病变中的作用。方法 采用PAP四层法对 18例LN患者肾组织MCP 1,CD68+ ,CD4 + ,及CD8+ 进行免疫组化染色。同时取 8例微小病变型肾病患者作为对照。结果 18例患者肾组织中均有不同程度的MCP 1染色阳性。其主要位于肾小管基侧膜 (16/ 18例 )及间质小血管壁 (9/ 18例 )上。对照组MCP 1阳性的小管明显低于狼疮性肾炎患者 (7 4± 6 2 %vs 2 6 7± 2 2 8% ,P <0 0 1)。LN患者肾间质中CD4 + ,CD8+ 及CD68+ 细胞数明显高于对照。其MCP 1阳性小管数与间质CD68+ 细胞浸润及间质病变的程度明显相关。而与CD4 + ,CD8+ 细胞浸润程度及患者尿蛋白的多少无相关性。结论 LN患者肾小管MCP
