局灶-节段性肾病患者蛋白尿促肾间质纤维化的探讨

Explore of Proteinuria from Patients with Focal-segmental Renal Synthesis on Renal Interstitial Fibrosis Progression

目的探讨局灶-节段性肾病(focal-segmental renal synthesis,FSG)患者蛋白尿对肾间质细胞纤维化的影响。方法提取FSG患者蛋白尿,进行蛋白成分分析、细菌内毒素试验、蛋白溶液的肌酐水平等质量鉴定后,试验组分别按1.0mg/ml、2.0mg/ml、4.0mg/ml、8.0mg/ml蛋白浓度刺激人肾小管上皮细胞(human renal tubular epithelialcells,hRTECs)48 h,空白组无尿蛋白。分别采用Hoechst33258染色法观察人hRTEC凋亡情况,Western blot检测RTECs胞浆中α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)表达,观察hRTEC转分化情况。结果 FGS尿蛋白组分构成:白蛋白59.9%、转铁蛋白15.3%、IgG13.8%。FSG患者尿蛋白诱导hRTECs的凋亡指数和α-SMA水平均随尿蛋白浓度的增加而增加(P<0.05)。结论 FSG患者的蛋白尿是导致肾间质纤维化的原因之一,并具有浓度依赖关系。

Objective To explore the effects of proteinuria from patents with the focal-segmental renal synthesis （FSG） on renal interstitial fibrosis progression. Methods Urinary protein from patients with FSG in renal synthesis was extracted. The protein composition, bacterial endotoxin test, protein creatinine level in urinary protein were evalutated. Urinary protein with concentration of 1.0 mg/ml, 2. 0 mg/ml, 4. 0 mg/ml, 8. 0 mg/ml were utilized to stimulate the hu- man renal tubular epithelial ceils （hRTECs） for 48 hours. The control group were cultured without urinary protein. The apoptosis of the hRTECs was observed by Hoechst33258 staining, a-smooth muscle actin （a-SMA） level in hRTECs was observed by Western blot. Results The urinary protein of FSG was composed of albumin （59. 9%）, transferring （15.3%） ,and IgG （13.8%）. The apoptosis index and a-SMA level in hRTECs were increased with the increase of the concentration of the uraine protein （P〈0. 05）. Conclusion Proteinuria of patients with FSG is one cause of renal intersti- tial fibrosis progression and there exists concentration dependence.