线粒体分裂相关蛋白与膜性肾病患者临床病理分析

Clinical and pathological analysis of mitochondrial fission-related proteins in patients with membranous nephropathy

目的探讨动力相关蛋白1(Drp1)及线粒体分裂蛋白1(Fis1)与膜性肾病(MN)患者临床病理的相关性。方法回顾性分析2017年1月至2018年12月30例经肾穿刺活检确诊的原发性膜性肾病患者临床资料,根据24 h尿蛋白定量分为大量蛋白尿组(≥3.5 g/d)及对照组(<3.5 g/d),应用免疫组织化学法检测两组患者肾病理组织中Drp1、Fis1的表达,比较其表达在两组患者间的差异,并进一步行相关性分析。结果Drp1、Fis1可在足细胞、系膜细胞、近端肾小管上皮细胞表达;Drp1在大量蛋白尿组组中的表达高于对照组(P<0.05),Drp1表达与24 h尿蛋白定量呈正相关(r=0.371,P<0.05);Fis1表达与年龄呈负相关(r=-0.482,P<0.05),与尿酸呈正相关(r=0.413,P<0.05)。结论Drp1的表达与MN患者蛋白尿存在正相关,提示线粒体动力学异常可能参与MN蛋白尿的发病机制。肾小管上皮细胞的线粒体动力学异常可能与MN患者早期肾小管损伤相关。

Objective To investigate the correlation between dynamic related protein 1(Drp1)and mitochondrial fission protein 1(Fis1)and clinicopathological features of patients with membranous nephropathy(MN).Methods Retrospective analysis of clinical data of 30 patients with primary membranous nephropathy diagnosed by renal biopsy from January 2017 to December 2018.According to the 24-hour urinary protein quantification,they were divided into a massive proteinuria group(≥3.5 g/d)and a control group(<3.5 g/d).The expression of Drp1 and Fis1 in the renal tissue of the two groups was detected by immunohistochemistry,and the difference between the two groups was compared.And further correlation analysis.Results Drp1 and Fis1 were expressed in podocytes,mesangial cells and proximal tubular epithelial cells.The expression of Drp1 in the massive proteinuria group was significantly higher than that in the control group(P<0.05),and the expression of Drp1 was positively correlated with 24-hour urinary protein quantification(r=0.371,P<0.05).The expression of Fis1 was negatively correlated with age(r=-0.482,P<0.05)and positively correlated with uric acid(r=0.413,P<0.05).Conclusion The expression of Drp1 is positively correlated with proteinuria in MN patients,suggesting that abnormal mitochondrial dynamics may be involved in the pathogenesis of MN proteinuria.Mitochondrial dynamics abnormalities in renal tubular epithelial cells may be associated with early renal tubular injury in MN patients.