狼疮肾炎中NGAL/NGALR的表达及临床意义

Expression and clinical significance of NGAL/NGALR in lupus nephritis

目的探讨中性粒细胞明胶酶相关性载脂蛋白(neutrophi gelatinase-associated lipocalin,NGAL)及其膜受体(neutrophi gelatinase-associated lipocalin receptor,NGALR)在狼疮肾炎(lupus nephritis,LN)中的表达及其临床意义。方法选择84例系统性红斑狼疮患者分为LN组和非LN组,另外组织标本对照选取同期武汉市中心医院泌尿外科肾癌切除术中癌旁正常组织。采用酶联免疫吸附试验检测LN患者及非LN患者血清及尿液中NGAL/NGALR的表达水平,免疫组化法检测LN患者与正常对照肾组织中NGAL/NGALR的表达,系统性红斑狼疮活动性指数评分采用1985年建立的SLEDAI-2000评分系统。采用SPSS 19.0软件进行数据分析,两组间比较采用t检验、多组间比较采用方差分析,相关性分析用Spearman等级相关分析法。结果 LN患者血液及尿液中NGAL/NGALR的表达显著高于非LN患者,差异具有统计学意义(P<0.01);尿液中NGAL/NGALR的表达水平与系统性红斑狼疮活动性指数评分呈正相关(P<0.01);LN患者肾组织中NGAL/NGALR的表达较正常肾组织增高,差异具有统计学意义(P<0.01)。结论 NGAL/NGALR在LN患者血液、尿液及肾组织中的异常表达及其与疾病活动程度的相关,提示NGAL/NGALR可能参与LN的发生发展,可辅助LN的临床诊断,同时为进一步研究NGAL/NGALR在LN的发病机制提供理论依据,为LN的研究提供新视点。

Objective To investigate the expression and clinical significance of NGAL/NGALR in lupus nephritis（ LN）. Methods Eighty-four patients with systemic lupus erythematosus（ SLE） were selected in this study,and divided into LN group and non-LN group. The normal tissues adjacent to carcinoma of kidney were chosen as controls,resected during the operation in Department of Urology,the Central Hospital of Wuhan. Enzyme-linked immunosorbent assay was used to detect the NGAL/NGALR expression level in serum and urine of the patients with or without lupus nephritis. Immunohistochemical method was used to detect the expression differences of NGAL/NGALR in lupus nephritis tissue and normal renal tissue. SLEDAI score was recorded by the SLEDAI-2000 scoring system（ version 1985）. SPSS 19. 0 software was applied for data analysis,t test for two-group comparison,variance analysis for multi-group comparison,and spearman rank correlation analysis for correlation analysis. Results The expression levels of NGAL/NGALR in lupus nephritis patients were significantly higher than in those without lupus nephritis in both serum and urine. The expression levels of NGAL/NGALR increased significantly in lupus nephritis tissues.Conclusions NGAL and NGALR may be closely related to the occurrence/development and the activity of lupus nephritis,which can assist the clinical diagnosis,and may be expected to become the new targets for therapy of lupus nephritis.