法尼醇X受体在终末期肾病血管钙化中的作用

The role of farnesoid X receptor expression in vascular calcification in ESRD

目的探讨法尼醇X受体(FXR)在终末期肾病(ESRD)患者桡动脉组织中的表达及其与血管钙化之间的关系。方法免疫组织化学染色观察正常桡动脉组织(n=5)和ESRD患者桡动脉组织(n=15)中FXR、CD68、Runx2表达,茜素红染色判断血管钙化,分析FXR阳性表达与CD68、Runx2、血管钙化之间的关系。结果正常桡动脉无钙化,15例患者11例出现血管钙化,钙化主要集中在血管中膜;FXR主要表达在血管平滑肌细胞,ESRD患者桡动脉FXR阳性表达积分较正常组织升高(P<0.01);FXR阳性表达积分与CD68阳性细胞积分无相关性,但与血管钙化积分、Runx2阳性细胞表达积分以及血低密度脂蛋白胆固醇和三酰甘油水平呈负相关(相关系数分别为-0.77、-0.68、-0.71和-0.62,均P<0.05);钙化积分与血磷、超敏C-反应蛋白(sCRP)及甲状旁腺激素(iPTH)呈正相关(相关系数分别为0.82、0.56和0.64,均P<0.05)。结论 ESRD患者桡动脉FXR阳性表达较对照组升高,FXR可能参与了血管钙化的发生。

【Objective】 To analyze the FXR expression in radial arteries and its correlation with vascular calcification in ESRD patients.【Methods】 Immunohistochemical staining was used to detect FXR expression and CD68-positive cells and Runx2 expression in normal（n =5） and ESRD（n =15） radial arteries tissue.The vessels were examined for calcification by alizarin red staining.【Results】 Radial artery calcification was mainly located in the medial layer,which occurred in 11 uremia patients.FXR was mainly expressed in vascular smooth muscle cells（VSMCs）.In ESRD patients,FXR positive points were increased（P ＆lt;0.01） than that in the normal tissue.FXR positive score showed no correlation with CD68-positive cell count,but showed a negative correlation with vascular calcification score,Runx2 positive score,serum low-density lipoprotein cholesterol and triglyceride levels（r values were-0.77,-0.68,-0.71 and-0.62 respectively,P ＆lt;0.01）.Vascular calcification score showed a positive correlation with the level of serum phosphorus,CRP and iPTH（r values were 0.82,0.56 and 0.64 respectively,P ＆lt;0.05）.【Conclusions】 The media layer of calcificated vascular from ESRD patients displayed increased FXR expression.FXR may be involved in the vascular calcificated response in ESRD.