足细胞在泼尼松干预局灶节段硬化性肾小球硬化的机制探讨

Invintestigation of the mechanism of podocytes in prednisone intervention of focal segmental sclerosis of glomerular sclerosis

目的：探讨足细胞在局灶节段硬化性肾小球疾病中的作用及泼尼松干预下足细胞相关蛋白的变化。方法：入选原发性局灶节段性肾小球硬化（FSGS）患者30例，收集治疗前及泼尼松治疗12周后患者尿液。荧光实时定量PCR法定量尿沉渣足细胞相关分子nehprin、podocinmRNA的表达水平，Western印记法检测尿液中WT1蛋白水平。结果：FSGS患者经治疗后24小时尿蛋白降低，血蛋白较治疗前升高，有统计学意义（P〈0．01）；尿沉渣足细胞nephrinmRNA表达水平治疗后较治疗前降低，差异有统计学意义（P〈0．01）；尿沉渣足细胞podocin mRNA治疗后较治疗前降低，差异有统计学意义（P〈0．01）；尿沉渣尿WT1蛋白治疗后较治疗前降低，差异有统计学意义。结论：①足细胞相关蛋白nephrin、podocalyxin与蛋白尿的发生发展密切相关；②泼尼松能减轻患者蛋白尿水平，nephrin、podocin在治疗过程中变化有可能和病情变化密切相关，但具体机制和变化有待进一步证实及研究。

Objective： To investigate the role of podocytes in focal segmental sclerosis of glomerular sclerosis （FSGS） and the expression of podocytes related proteins in FSGS parents treated with prednisone. Methods： The urine of 30 patients with FSGS was collected including pretreated and treated with prednisone after 12 weeks. Urinary sediment podocyte associated molecular nephrin and podocalyxin mRNA expression was quantified by real-time PCR. Podocytes associated molecular Wilms Tumor 1 （WT1） protein expression was quantified by western blot. Results： 24-hour urine protein （24hUP） were significantly lower than pretreatment group and serum albumin （Alb） were significantly higher than preatreatment group （P〈0.05） ; The expressions ofnephrin and podocin mRNA in urinary sediment of treatment group were lower than pretreatment group and there were significantly differences. Conclusion： ①Nephrin and podocin are intimately correlated with the progression ofproteinurine.②The prednisone could effectively reduce proteinurine, there are closely relationship between the expression ofnephrine and podocin and the disease progress.