肾炎患者肾组织中乙型肝炎病毒Pre-S2蛋白的检测及意义

Detection of pre-S2 protein in the kidney in patients with glomerulonephritis

对30例经肾活检确诊为肾炎的患者,应用单克隆抗体和间接免疫酶标技术检测肾组织中的Pre-S_2蛋白,同时对肾脏中的HBsAg,HBeAg及血清HBsAg,HBeAg,抗HBs,抗HBe,抗HBc进行了观察。结果显示:7/22例原发性肾炎和6/8例狼疮性肾炎患者的肾小球中有Pre-S_2蛋白沉积,分布于毛细血管袢及(或)系膜区,其分布与肾炎类型、肾组织中免疫球蛋白和补体沉积的多少有关。肾脏中Pre-S_2蛋白的沉积与相同部位HBsAg的沉积有联系,与HBeAg的沉积无关。膜性肾病者Pre-S_2蛋白的沉积与病毒血症有良好的柑关性;狼疮性肾炎者Pre-S_2蛋白的沉积很可能是非特异性的。

The presence of pre-S2 protein in the kidney was investigated in 30 patients with biopsy-proved glomerulonephritis(GN)using indirect immunoperoxidase technique and monoclonal antibody. HBsAg and HBeAg in the kidney were detected using the same techniques and HBsAg, HBeAg, anti-HBs, anti-HBe and anti-HBc in serum were assayed at the same time. It was shown that pre-S2 protein was present in the kidney in 7/22 patients with primary GN and 6/8 with lupus nephritis. Pre-S2 deposited along glomerular capillary wall or within the mesangium depending on the type of GN as well as the deposition of immunoglobulins and complement components in the kidney. Deposition of pre-S2 protein in reanl tissue was correlated with the HBsAg deposition in the glomeruli, not the HBeAg deposition. In membranous GN there was a good correlation between the presence of pre-S2 protein in the kidney and virus antigenemia. It was concluded that pre-S2 protein detection in the kidney was of value in evaluating the hepatitis B virus associated GN.