Smad7及Foxp3分子在慢性移植肾肾病检测中的临床应用

Clinical Application of Detection of Smad7 and Foxp3 Proteins in Chronic Allograft Nephropathy

目的:研究Smad7和Foxp3在慢性移植肾肾病(CAN)中的作用以及两指标在该疾病中的潜在联系。方法:应用ELISA法和原位杂交技术分别检测32例不同病理分级CAN(其中CANⅠ级10例,Ⅱ级9例,Ⅲ级13例)患者外周血中及活检标本当中的Smad7和Foxp3水平,另取9例移植后肾功能正常志愿患者的活检标本和外周血标本做为对照。结果:CAN各级的Smad7和Foxp3表达水平无论是外周还是活检标本当中皆明显低于对照组的表达水平(P<0.05),而CANⅠ级与CANⅡ级差异无统计学意义(P>0.05),CANⅠ级和CANⅡ级对比CANⅢ级的表达水平差异有统计学意义S(P<0.05),Smad7和Foxp3的表达有明显联系(P<0.05),而有3例标本两者的表达差异较大。结论:移植肾活检穿刺能客观的反映CAN的病理变化,而外周血当中的Smad7和Foxp3水平基本能够反映CAN的发展程度,是检测CAN的一个不错的无创指标,Smad7和Foxp3对慢性移植肾肾病的发生发展起重要作用,而Smad7可能通过某种机制调控Foxp3的表达。

Objective：To investigate the use of expression of Smad7 and Foxp3 proteins in chronic allograft nephropathy and the potential links between Smad？ and Foxp3. Methods：The expression of Smad7 and Foxp3 in 32 patients with CAN（CAN I grade in 10 cases,CAN I1 grade in 9 cases,CAN III grade in 13 cases）and 9 patients as a control with stable renal graft function after renal transplantation were examed with ELISA and immunohisto-chemical staining in perpheral blood and transplant biopsy sample. Results ： Level of Smad7 and Foxp3 in CAN were significantly lower than that in patients with stable renal graft function not only in perpheral blood but also in transplant biopsy sample （P〈0.05）. The level of the two molecular markers was not significantly different betwwen CAN I grade and CAN II grade（P〉0.05）. The level of the two molecular markers in CAN I and CAN II grade was significantly higher than that in CAN III grade （P〈0.05）. The expression of Smad7 was related with the expression of Foxp3 （P〈0.05）, but there was quite different in the expression of the 3 specimens. Conclusions： Transplant biopsy sample can reflect objectively pathological change in CAN. The level of Smad7 and Foxp3 in peripheral blood that can serve as a good and non-invasive marker reflects basically the degree of development in CAN. Smad7 and Foxp3 play an important role in the development of CAN and Smad7 can regulate and control Foxp3 via a sort of mechanism.