乙型肝炎病毒感染在IgA肾病发病中的作用

Role of hepatitis B virus infection in pathogenesis of IgA nephropathy

目的 探讨乙型肝炎病毒 (HBV)感染与IgA肾病的关系。方法 采用免疫组化技术检测肾组织HBV抗原 (HBAg) ,应用原位分子杂交技术和Southern印迹杂交技术检测肾组织HBVDNA。结果 1 0 0例IgA肾病患者中 ,血清HBsAg阳性 1 8例 (1 8% ) ;肾组织HBAg阳性 31例 (31 % ) ,HBAg在肾小球中阳性率为 65 % (2 0 /31 ) ,其中HBsAg为 32 % (1 0 /31 ) ,HBcAg为 32 % (1 0 /31 ) ;除肾小球外 ,HBcAg在肾小管上皮细胞和肾间质亦有阳性沉积 ,分别为 1 4例 (45 % )和 2例 (6 % ) ;Southern印迹杂交证实 6例患者中 5例肾组织有整合型HBVDNA ;原位分子杂交证实肾小管和肾小球中HBVDNA阳性率分别为 1 0 0 % (8/8)和 75 % (6/8) ;定位于肾小管上皮细胞、肾小球细胞和肾间质浸润的淋巴细胞中。结论 HBV感染与IgA肾病密切相关 。

Objective To clarify the relationship between hepatitis B virus (HBV) infection and IgA nephropathy (IgAN) Methods HBV antigen (HBAg) in renal tissues of the patients with IgAN was detected by immunohistochemical technique, the carrier status and localization of HBV DNA in renal tissues were determined by Southern blot analysis and in situ hybridization Results Serum HBsAg was detected in 18 of the 100 patients with IgAN (18%), HBAg was detected in 31 of 100 patients (31%) in their renal tissue and in 20 of 31 patients (65%) in their glomeruli, and both HBsAg and HBcAg were detected in 10 of 31 patients (32%), respectively HBcAg was also found in tubular epithelia (45%, 14/31) and renal interstitium (6%, 2/31), respectively Five of six cases were proved to be positive of integrated form HBV DNA in their renal tissue by Southern blot analysis In situ hybridization demonstrated that HBV DNA was 8/8 and 6/8 positive in their renal tubules and glomeruli of all eight specimens, localized in the nucleus of tubular epithelial cells, glomerular mesangial cells, as well as infiltrated interstitial lymphocytes Conclusion HBV infection closely related with IgAN and HBV infection might be involved in pathogenesis of IgAN