IgA肾病肾组织中基质金属蛋白酶2和单核细胞趋化因子1的表达

Renal expression of MMP-2 and MCP-1 in patients with IgA nephropathy

目的探讨基质金属蛋白酶2（MMP-2）和单核细胞趋化因子-1（MCP-1）在IgA肾病肾组织的表达强度及其在该病早期肾损害发病机制中的作用。方法将30例IgA肾病患者经肾脏活体组织检查的。肾组织和1（）例切除肾肿瘤患者正常肾组织，进行MMP-2、MCP-1、Ⅳ型胶原免疫组织化学检测并进行半定量分析，按其组织学改变Lee分级标准和肾小管间质病变程度进行分组和分级，同时检测肾功能、24h尿蛋白定量等临床指标，并与组织学、免疫组织化学检测结果进行相关分析。结果在IgA肾病轻度肾损害阶段，MMP2和MCP-1表达水平显著高于正常对照（P〈0．05），随着病变级别加重，MMP-2和MCP-1在肾小管间质的表达呈逐渐减少趋势（P〈0．05），而Ⅳ型胶原在肾小管间质表达随肾损害加重呈逐渐增加趋势（P〈0．01）。Spearman相关分析显示，MMP-2和MCP-1表达水平与肾小管间质炎症细胞浸润程度呈正相关（P〈0．05），与Ⅳ型胶原表达水平呈负相关（P〈0．05）。结论MMP-2和MCP-1可能参与IgA肾病早期单个核细胞浸润等早期肾损害发病机制。

Objective To investigate the renal expression of MMP-2, and MCP-1 in patients with IgA nephropathy and its role in the pathogenesis of the disease at early stage. Methods Imrnunohistochemical staining of MMP 2 and MCP-1 and semi-quantitative analysis were performed in the renal biopsy tissue of 30 patients with IgA nephropathy and the normal renal tissues from 10 cases of renal tumors. The patients were divided into groups according to Lees histological classification and the degree of tubulointerstitial disorders. Correlative analysis was performed between their renal function, 24-h urine protein excretion, etc, and histological changes and immunohistochemical staining. Results Based on Lee＇s classification and the degree of tubulointerstitial disorders, the expression level of MMP- 2 and MCP-1 in groups with mild and moderate renal disease was significantly higher than normal controis （P〈0. 05）. Along with the aggravation of renal diseases, the expression of MMP-2 and MCP 1 in tubulointerstitium showed a tendency of decrease （P 〈 0. 05）, while the expression of collagen IV showed a tendency of increase（P〈0. （15）. Spearman correlation analysis revealed that the expression of MMP-2 in tubulointerstitium was positively correlated with tubulointerstitial inflammatory infiltration （r= 0. 75,r = 0. 68, P〈0.05）, but negatively with the expression of collagen Ⅳ（r = - 0. 60, P〈 0. 05）. Conclusion MMP-2 and MCP-1 may contribute to the pathogenesis of IgA nephropathy,including tubulointerstitial monocyte infiltration,at the early stage of the disease.