Toll样受体3和Toll样受体4在原发性IgA肾病患儿肾组织中的表达及意义

Significance of the expression of Toll-like receptor 3 and Toll-like receptor 4 in renal tissues of children with primary IgA nephropathy

目的探讨Toll样受体(Toll-like receptor,TLR)3和TLR4在原发性IgA肾病患儿肾组织中的表达及意义。方法选择2014年7月至2019年6月新乡医学院第一附属医院收治的64例原发性IgA肾病患儿为研究对象,所有患儿于超声引导下定位穿刺获取肾组织标本行病理学检查,根据牛津分类法将患儿分为M0组(10例)和M1组(54例)。另选择同期行肾脏切除的7例肾肿瘤患者为对照组,取距离肿瘤组织2 cm以上的正常肾组织的肾皮质。采用免疫组织化学法检测所有患儿肾组织中TLR3和TLR4的表达。结果对照组患儿肾小管上皮细胞及肾小球系膜细胞中可见少许TLR3表达,M0组和M1组患儿肾小管上皮细胞和肾小球系膜细胞中TLR3表达升高。对照组患儿肾小球系膜细胞、肾小管上皮细胞中TLR4无明显表达;M0、M1组肾小管上皮细胞中TLR4表达明显升高,而肾小球系膜细胞中有少量表达。M0组、M1组和对照组患儿肾组织中TLR3阳性表达率分别为(65.49±7.00)%、(70.68±6.80)%和(9.97±1.41)%;M0组、M1组和对照组患儿肾组织中TLR4相对表达量分别为0.029±0.008、0.059±0.015和0.003±0.001;M1组患儿肾组织中TLR3阳性表达率和TLR4相对表达量显著高于M0组和对照组(P<0.05),M0组患儿肾组织中TLR3阳性表达率和TLR4相对表达量显著高于对照组(P<0.05)。结论TLR3和TLR4在原发性IgA肾病患儿肾组织中表达上调,且其表达水平可能与系膜增生程度有关。

Objective To investigate the significance of the expression of Toll-like receptors(TLR)3 and TLR4 in renal tissues of children with primary IgA nephropathy.Methods Sixty-four children with primary IgA nephropathy admitted to the First Affiliated Hospital of Xinxiang Medical University from July 2014 to June 2019 were selected as the research subjects.All children underwent ultrasound-guided puncture to obtain renal tissue samples for pathological examination,and the children were divided into M0 group(n=10)and M1 group(n=54)according to the Oxford classification.In addition,7 patients with renal tumors who underwent nephrectomy at the same time were selected as the control group,and the renal cortex of normal renal tissue more than 2 cm away from the tumor tissue was selected.The expression of TLR3 and TLR4 in renal tissues was detected by immunohistochemistry.Results There was a little expression of TLR3 in the renal tubular epithelial cells and glomerular mesangial cells of children in the control group,while the expression of TLR3 in the renal tubular epithelial cells and glomerular mesangial cells of children in the M0 and M1 groups was significantly increased.There was no significant expre-ssion of TLR4 in glomerular mesangial cells and renal tubular epithelial cells of children in the control group.The expression of TLR4 in renal tubular epithelial cells of children in the M0 and M1 groups was significantly increased,while there was a little expression of TLR4 in glomerular mesangial cells.The positive expression rate of TLR3 in renal tissues of children in the M0 group,M1 group and control group was(65.49±7.00)%,(70.68±6.80)%and(9.97±1.41)%,respectively.The relative expression of TLR4 in renal tissues of children in the M0 group,M1 group and control group was 0.029±0.008,0.059±0.015 and 0.003±0.001,respectively.The positive expression rate of TLR3 and the relative expression of TLR4 in renal tissues of children in the M1 group were significantly higher than those in the M0 group and control group(P<0.05),and the positive expression rate of TLR3 and the relative expression of TLR4 in renal tissues of children in the M0 group were significantly higher than those in the control group(P<0.05).Conclusion The expression of TLR3 and TLR4 are up-regulated in renal tissues of children with primary IgA nephropathy,and their expression levels may be related to the degree of mesangial hyperplasia.