Foxp3在乙型肝炎病毒相关性肾炎肾组织中的表达及其意义

Significance of expression of forkhead/winged helix transcription factor in HBV-associated glomerulonephrititis

目的:研究叉状头/翅膀状螺旋转录因子(Foxp3)在乙型肝炎病毒相关性肾炎(HBV-GN)肾组织中的表达及其意义.方法:所有病例经肾组织活检病理诊断.分组:A组为乙型肝炎相关性肾炎组(n=58);B组为非乙型肝炎肾炎组(n=52);C组为HBV感染对照组(n=24),患者血清HBsAg阳性、肾组织中HBsAg阴性,血清肌酐轻度升高经肾组织活检排除肾炎.利用免疫组织化学法检测3组患者肾组织Foxp3、CD4、CD25蛋白表达情况.结果:(1)A、B、C3组患者在年龄(F=1.02,P=0.36)、性别(x2=1.09,P=0.57)、民族构成(x2=0.04,P=0.98)、血清肌酐(F=0.05,P=0.61)、谷丙转氨酶(F=0.06,P=0.76)等方面差异均无统计学意义;但A组与B组尿蛋白(>0.3g/24h)差异有统计学意义(P<0.05);(2)A组和B组病理类型构成比较差异无统计学意义(x2=1.08,P=0.99),但肾小管间质损伤程度比较差异有统计学意义(x2=9.15,P=0.027),且A组肾小管间质损伤程度较B组重;(3)Foxp3、CD4、CD25蛋白主要表达于肾小管间质;在A组与B组肾小管间质中,每高倍镜视野下Foxp3+淋巴细胞、CD4+T细胞、CD25+T细胞数分别为(3.41±1.16)vs(3.52±1.27);(2.78±0.15)vs(3.12±0.17);(2.90±0.20)vs(3.09±0.18),均明显低于C组Foxp3+淋巴细胞数、CD4+T细胞、CD25+T细胞数(均P<0.05);A组与B组比较,差异有统计学意义(P<0.05),A组中,Foxp3、CD4、CD25的表达低于B组.结论:调节性T细胞Foxp3表达水平的下调可能与乙型肝炎病毒相关性肾炎的发生发展有关.

AIM： To investigate the expression and possible role of forkhead/winged helix transcription factor （Foxp3） in the kidney tissue of patients with hepatitis B virus-associated glomerulonephritis （HBV-GN）. METHODS： Patients who were pathologically diagnosed by renal biopsy were divided into three groups. Group A had HBV-GN （n=58）, group B had HBsAg-negative nephritis （n=52）, and group C consisted of HBV controls （n=24）, whose serum was HBsAg-positive, renal tissue HBsAg-negative and creatinine slightly elevated but without renal lesion. Immunohistochemistry was utilized to detect the expression of Foxp3 protein in kidney tissue of patients. RESULTS： （1） There was no significant dif- ference in age （F=1.02, P=0.36）, gender （x^2 = 1.09, P=0.57）, ethnicity composition （x^2=0.04, P=0.98）, serum creatinine （F=0.05, P=0.61）, or alanineaminotransferase （F=0.06, P=0.76） among the three groups. However, there was a statistical difference between group A and group B in urine protein （ 0.3 g/24 h）; （2） There was no significant difference in pathological type between groups A and B （x^2=1.08, P=0.99）; however, the extent of tubular interstitial injury （x^2=9.15, P =0.027） was more serious in group A; （3） Foxp3, CD4, and CD25 proteins were expressed mainly in the tubulointerstitial tissue. There were significant differences in the number of Foxp3＋ lymphocyte, CD4＋ T cells and CD25＋ T cells per highpower field between group A and group B （3.41 ± 1.16 vs 3.52 ± 1.27; 3.12 ± 0.17 vs 2.78 ± 0.15; 2.9 ± 0.2 vs 3.09 ± 0.18, all P0.05）. The numbers of Foxp3＋ lymphocyte, CD4＋ T cells, and CD25＋ T cells per high-power field in groups A and B were significantly lower than those in group C （all P0.05）. CONCLUSION： The occurrence and development of HBV-GN may be related to reduced expression of Foxp3 in regulatory T cells.