儿童狼疮肾炎肾脏组蛋白(核小体)检测意义

Detection of Histone(Nucleosome) and Its Value in Children with Lupus Nephritis

目的通过检测狼疮肾炎(LN)患儿肾脏中的组蛋白,探讨核小体在儿童LN肾脏中的沉积及可能的意义。方法用间接免疫荧光法检测27例LN患儿、10例正常对照肾组织冰冻切片中组蛋白和抗IgG抗体的沉积,同时用酶联免疫吸附测定法检测LN患儿血清抗双链DNA(dsDNA)、抗组蛋白及抗核小体抗体。结果 27例LN患儿中,21例肾脏组蛋白染色阳性(病理分类Ⅱ型1例、Ⅲ型3例、Ⅳ型14例、Ⅴ型3例),不同病理类型间组蛋白的染色强度差异无统计学意义(H=8.71,P>0.05),染色部位主要分布于系膜区和基底膜,对照者肾组织组蛋白染色均为阴性。21例肾脏组蛋白染色阳性LN患儿中,1例肾脏抗IgG抗体染色阴性;其余6例肾脏组蛋白染色阴性患儿肾脏抗IgG抗体染色均为阳性。27例LN患儿血清中均存在不同程度的抗dsDNA、抗组蛋白和抗核小体抗体。结论组蛋白(核小体)在肾脏沉积与儿童LN发病有关。但LN的发病机制复杂,组蛋白(核小体)介导的免疫复合物沉积并非唯一的致病机制。

Objective Nucleosome is composed of histones and DNA.This study is aimed to discuss the deposition of nucleosome in kidney and its value by detecting histones in the kidney of children with lupus nephritis（LN）.Method The deposition of histones and anti-IgG antibody was detected in 27 children with LN and 10 normal controls in frozen tissue sections by indirect immunofluorescence.In parallel,antibodies against ds-DNA,histones,and nucleosome in the serum samples were tested by ELISA.Result Of the 27 children with LN,21 were positive to histones（1 case of typeⅡ,3 cases of typeⅢ,14 cases of typeⅣ,and 3 cases of typeⅤ）.There was no statistical significant difference of staining intensity of histones among different pathological types（H=8.71,P〉0.05）.Positive stains were mainly located in the mesangial region and basement membrane while all nephron from normal controls were negative to histonesstain.Among the 21 children with LN who were positive to histone stain,1 case was negative to anti-IgG antibody stain in kidney.The anti-IgG antibody stain of the other 6 children with LN were negative but were positive to histone stain.In all of the serum samples of 27 children with LN,antibodies against ds-DNA,histones,and nucleosome could be detected in different degree.Conclusion Histones（nucleosome） deposition in kidney is related to the ocurrence of LN in children.However,the pathogenesis of LN is complex.Immunocomplex deposition mediated by histones（nucleosome） may be not the only mechanism for the development of lupus nephritis in children.