IgA肾病骨桥蛋白、CD68的表达及其与肾间质损伤的关系

Expressions of osteopontin and CD68 and their relationship with renal interstitial injury in IgA nephropathy

目的:探讨IgA肾病骨桥蛋白(Osteopontin,OPN)、CD68的表达及其与肾间质损伤的关系。方法:根据肾活检结果选取26例已经确诊的原发性IgA肾病的肾组织作为实验组。按Lee氏法将肾组织病理损害分为Ⅰ～Ⅴ级并将肾间质损伤分为0～3级。另取4例因肾外伤或肾肿瘤切除的患肾中的正常肾组织作为对照组。免疫组化法检测肾组织中OPN、CD68的表达,RT-PCR技术检测肾组织OPN mRNA的表达。结果:(1)IgA肾病中有高达86%的患者伴有不同程度肾间质损伤。实验组肾间质中CD68的表达较对照组显著增高,差异有统计学意义。(2)实验组OPN、OPN mRNA的表达均较正常组显著升高(P<0.05)。OPN、OPN mRNA的表达与肾间质损伤程度无相关性。肾间质内CD68的表达与肾间质损害成正相关。OPN的表达与肾间质内CD68的表达呈正相关(rs=0.545,P=0.044)。结论:单核/巨噬细胞的浸润参与了IgA肾病肾间质的损伤。OPN与炎症有关,它通过介导单核巨噬细胞的浸润参与IgA肾病肾间质的损伤。

Objectve：To investigate the expressions of osteopontin（OPN）and CD68 in IgA nephropathy and their relationship with renal interstitial injury.Methods：According to biopsy results,renal biopsy specimens from 26 patients with diagnosed primary IgA nephropathy were selected as experimental group.According to Lee’s method,pathological injuries were divided intoⅠ-Ⅴ grades and renal interstitial injuries were divided into 0-3 levels.The other four normal renal tissue specimens taken from patients with renal trauma or renal tumor were taken as control group.Blood pressure,serum creatinine,creatinine clearance rate were collected and calculated.Expressions of OPN and CD68 in renal tissues were investigated by immunohistochemistry.mRNA expressions of OPN were investigated by RT-PCR.Results：（1）Up to 86% patients with IgA nephropathy had renal interstitial injury.Expressions of CD68 in experiment group were significantly higher than those in control group,with statistical differences.（2）Expressions of OPN and mRNA were higher in experiment group than in control group（P0.05）and were not correlated with renal interstitial injuries.Expressions of CD68 in renal interstitial substance were positively correlated with renal interstitial injuries.Expressions of OPN were positively correlated with expressions of CD68 in renal interstitial substance（r s =0.545,P=0.044）.Conclusions：Monocyte/macrophage infiltration in IgA nephropathy is involved in renal interstitial injury.OPN,associated with inflammation,participates in renal interstitial injury by mediating mononuclear and macrophages.