MCP-1、TLR-4及尿蛋白定量与原发性IgA肾病病理损伤的相关性研究

Correlations Study between MCP-1,TLR-4 and Urinary Protein Quantitation with Pathological Damage in Patients with Primary Ig A Nephropathy

目的探讨原发性Ig A肾病(Ig A nephropathy,Ig AN)肾组织中单核细胞趋化蛋白-1(MCP-1)、Toll样受体4(TLR-4)表达及24 h尿蛋白定量水平,分析其与肾脏损伤程度的相关性。方法选择2015年1月—2017年8月收治的67例原发性Ig AN患者。所有患者取肾活检标本,采用免疫组化法测定肾组织中MCP-1与TLR-4的表达,采用免疫比浊法测定24 h尿蛋白定量。比较不同Lee分级和肾小管间质损伤分级患者间MCP-1、TLR-4表达及24 h尿蛋白定量水平,并进一步分析MCP-1、TLR-4表达与24 h尿蛋白定量间的相关性。结果原发性Ig AN患者MCP-1及24 h尿蛋白定量水平随着Lee病理分级和肾小管间质损伤程度的加重均有升高趋势(P <0. 01),而不同Lee分级和肾小管间质损伤分级原发性Ig AN患者TLR-4表达水平比较差异无统计学意义(P> 0. 05)。原发性Ig AN肾组织中MCP-1、TLR-4表达与24 h尿蛋白定量呈正相关(r=0. 5 281、0. 6 262,P <0. 01)。结论 MCP-1与原发性Ig AN存在密切关系,其表达可作为判断原发性Ig AN病变程度的重要指标;尿蛋白是Ig AN进展及预后的危险因素。

Objective To investigate correlations between monocyte chemotactic protein-1(MCP-1)and Toll like receptor 4(TLR-4)expressions and level of urine protein quantitation within 24 h in renal tissues of patients with primary IgA nephropathy(IgAN)with degree of renal injury.Methods Renal biopsy specimens were taken from 67 patients with primary IgAN admitted during January 2015 and August 2017.Expressions of MCP-1 and TLR-4 in renal tissues were detected by immunohistochemistry method,and urine protein quantitation within 24 h was detected by immunoturbidimetry.MCP-1 and TLR-4 expressions and urine protein quantitation within 24 h were compared among patients with different Lee classification and kidney tubules mesenchymal injury,and correlations between MCP-1 and TLR-4 expressions with urine protein quantitation within 24 h were further analyzed.Results Levels of MCP-1 and urine protein quantitation within 24 h in patients with primary IgAN were increased with aggravation of Lee pathological grades and degrees of kidney tubules of mesenchymal injury(P<0.01).There were no significant differences in TLR-4 expressions among primary IgAN patients with different Lee grades and degrees of kidney tubules of mesenchymal injury(P>0.05).MCP-1 and TLR-4 expressions were positively correlated with urine protein quantitation within 24 h in primary IgAN renal tissues(r=0.5 281,0.6 262,P<0.01).Conclusion MCP-1 has a close correlation with primary IgAN,and its expression can be used as judging degree of renal pathological changes in primary IgAN renal tissues.Urinary protein is a risk factor for progression and prognosis of IgAN.