脯氨酰羧基肽酶和血管紧张素转化酶2在IgA肾病中的表达及其病理意义

Expression and Pathological Significance of Prolyl Carboxypeptidase and Angiotensin Converting Enzyme 2 in IgA Nephropathy

目的:探讨IgA肾病组织中肾素-血管紧张素(RAS)系统相关蛋白脯氨酰羧基肽酶(PRCP)、血管紧张素转化酶2(ACE2)的表达及意义。方法:选取54例IgA肾病患者[20例局灶增生性IgA肾病、20例IgA肾病合并膜性肾病(MN)及14例新月体性IgA肾病]的肾穿刺组织标本作为IgA肾病组,20例微小病变肾病(MCD)的肾穿刺组织标本作为对照组,采用免疫组化法检测2组患者肾穿刺组织的PRCP、ACE2表达,分析PRCP、ACE2表达与各类型IgA肾病病变程度的关系。结果:PRCP、ACE2在IgA肾病组的表达量高于对照组(P<0.05);在IgA肾病组,随着患者的病变程度的加重,PRCP、ACE2蛋白在肾小球区域的表达呈逐渐上升趋势,而在肾小管区域的表达量呈下降趋势,差异有统计学意义(P<0.05);PRCP与IgA在肾小球的沉积存在负相关(r=-0.301,P=0.027),ACE2与IgA在肾小球的沉积存在正相关(r=0.306,P=0.024)。结论:PRCP、ACE2在IgA肾病的肾组织中表达,并随着病变加重,表达水平在肾小球和肾小管区域呈不同趋势。

Objective:To investigate the expression and significance of prolyl carboxypeptidase(PRCP)and angiotensin converting enzyme 2(ACE2)in IgA nephropathy.Methods:Renal biopsy specimens from 54 patients[20 cases of focal proliferative IgA nephropathy,20 cases of IgA nephrotic syndrome with membranous nephropathy(MN)and 14 cases of crescent IgA nephropathy]with IgA nephropathy were selected as IgA nephropathy group.The PRCP and ACE2 expression of renal puncture tissue in 20 patients with minimal lesion nephropathy(MCD)was detected by immunohistochemistry in the control group to analyze the relationship between PRCP as well as ACE2 expression and the degree of IgA nephropathy.Results:The expression of PRCP and ACE2 in IgA nephropathy group was higher than that in control group(P<0.05).The expression of PRCP and ACE2 protein increased gradually in the glomerular region and decreased in the renal tubule region in the IgA nephropathy group with the increase of lesion degree,and the difference was statistically significant(P<0.05).PRCP was negatively correlated with IgA deposition in glomeruli(r=-0.301,P=0.027)and positively correlated with IgA deposition in glomeruli(r=0.306,P=0.024).Conclusion:PRCP and ACE2 are expressed in the renal tissue of IgA nephropathy,and with the aggravation of the lesion,the expression level shows different trends in the glomerular and tubular regions.