MCP-1在IgA肾病患者肾组织中的表达

Expression of MCP-1 in renal tissues of patients with IgA nephropathy

目的:检测IgA肾病患者肾活检组织中的单核细胞趋化蛋白-1(MCP-1)的表达,并对其表达水平与病变类型进行相关性分析。方法:88例IgA患者肾活检组织,根据病理改变分为轻微病变型、系膜增生型、局灶硬化型和弥漫硬化型4组,免疫组织化学SP法检测MCP-1和CD68在肾组织中的表达,采用图像分析法对其表达进行半定量分析,同时收集患者的一般临床资料。结果:肾小球中MCP-1表达在4组中无统计学差异,而在肾小管间质中MCP-1的表达分别为轻微病变组1.43±0.60、系膜增生组5.98±0.92、局灶硬化型组10.60±0.76、弥漫硬化型组11.65±0.39,局灶硬化型组、弥漫硬化型组明显高于轻微病变组、系膜增生组,差异有统计学意义(P<0.01);肾小球内几乎未见CD68+细胞;而肾小管间质中CD68的表达在4组中分别为:0.75±0.71,5.87±0.96,10.42±0.61,11.40±0.49,差异有统计学意义(P<0.01)。MCP-1在肾小管间质内的表达与CD68在肾小管间质中的表达呈正相关(r=0.688,P<0.01);MCP-1在肾小管间质内的表达与24 h尿蛋白量呈明显正相关(r=0.531,P<0.01)。结论:MCP-1对IgA肾病患者肾组织中单核细胞的浸润起重要作用,MCP-1的表达水平与肾脏损害的程度及临床预后相关。

Objective To investigate the differential expression of monocyte chemoattractant protein-1（MCP-1） in renal biopsy tissues of patients with IgA nephropathy,and to analyse the association between these 2 markers and their effect on various pathologic types of IgA nephropathy.Methods According to pathologic type,88 renal biopsy tissues of patients with IgA nephropathy were divided into 4 groups：a minimal change group,a mesangial proliferative glomerulonephritis group,a focal sclerosing glomerulonephritis group,and a diffused sclerosing glomerulonephritis group.Immunohistochemical staining was used to detect the in situ expression of MCP-1 and CD68 on renal biopsy tissues.The expression levels were semi-quantified by image analysis and clinical data were collected from the patients.Results The differences in glomerular MCP-1 expressions were not statistically significant among all groups,while the tubulointerstitial MCP-1 expressions were statistically different among the 4 groups,with the average scores of 1.43±0.60,5.98±0.92,10.60±0.76 and 11.65±0.39 for minimal change group,mesangial proliferative glomerulonephritis group,focal sclerotic glomerulonephritis,and diffused sclerotic glomerulonephritis group,respectively.The tubular and interstitial CD68 scores were 0.75±0.71,5.87±0.96,10.42±0.61,and 11.40±0.49 for the 4 groups,with significant differences in both MCP-1 and CD68 among the 4 groups.Correlation analysis indicated a positive correlation between tubulointerstitial MCP-1 and CD68（r=0.688,P〈0.01）.MCP-1 in tubulointerstitial was significantly correlated with 24 h urinary protein excretion（r=0.531,P〈0.01）.Conclusion MCP-1 plays a critical role in macrophage infiltration in the kidney.MCP-1 is associated with the severity of tubulointerstitial damage and clinical prognosis.