肾组织中CD80和CD86的表达及其与肾间质损伤的关系

Expressions of CD80 and CD86 in renal tissue and their correlation to interstitial kidney lesion

目的探讨T淋巴细胞活化分子CD80与CD86在原发性肾小球肾炎肾小管间质损伤中的作用。方法采用免疫组织化学法检测原发性肾小球肾炎患者肾组织中的CD80与CD86的表达情况,免疫比浊法检测24h尿蛋白定量,全自动生化分析仪检测血尿素氮、血清肌酐及血浆白蛋白等临床指标。结果 CD80和CD86在原发性肾小球肾炎肾组织中的表达情况不同。CD80在肾小管上皮细胞、肾间质有阳性表达,在肾小球无表达,而CD86在肾小管上皮细胞、肾间质及肾小球均有表达。CD80和CD86在肾小管间质中的表达水平随着原发性肾小球肾炎患者肾小管间质病变程度的加重而增强(相关系数分别为0.741和0.736,P<0.001),并且CD80的表达与CD86的表达成正相关。CD80和CD86的表达与患者24h尿蛋白定量、血尿素氮和血清肌酐水平成正相关;与肌酐清除率成负相关。结论 T细胞的活化可能参与了原发性肾小球肾炎肾间质损伤。

Objective Glomerulonephritis（GN） is a major cause of end-stage renal failure in China.Tubulointerstitial cell infiltration is involved in the tissue destruction and therefore in renal dysfunction.The infiltration cells in renal tissue are mostly T lymphocytes and monocytes/macrophages.Activation of T-cells requires costimulatory signals through binding of CD28 receptor with cognate ligands（CD80 and CD86） located on antigen-presenting cells（APC）.The aim of this study was to define the mechanisms by which CD80 and CD86 regulate the development of primary glomerulonephritis.Methods Eighty-nine patients with primary glomerulonephritis were studied.Tubulointerstitial lesions were divided into grade 1 to grade 4（negative to severe tissue damage） by using Katafuchi scale.The expression of CD80 and CD86 in renal tissues was detected by immunohistochemical methods.Results The expression and distribution patterns of CD80 and CD86 were different in patients with primary glomerulonephritis.CD86 was expressed extensively in glomerulus,periglomerular area,tubular epithelial cells,and peritubular interstitium,while CD80 was expressed only in some tubular epithelial cells and peritubular interstitium.Moreover,the percentage of CD80＋ and CD86＋ cells in peritubular interstitium showed a tendency to increase with tubulointerstitial damage（r =0.741,P〈0.001;r =0.736,P〈0.001,respectively）.The expression of CD80 and CD86 significantly correlated with the amount of 24-hour proteinuria and creatinine clearance.Conclusion This study clearly shows that the increase of CD80 and CD86 expression with the progression of tubulointerstitial lesion may play an important role in primary glomerulonephritis.The expression of CD80 and CD86 correlates with renal function at the time of biopsy.The costimulatory molecules CD80 and CD86 may involve in the pathogenesis of primary glomerulonephritis.