IgA肾病肾组织中OPN、TGF-β1的表达及其与临床、病理的关系

Expressions of OPN and TGF-β1 in renal tissue of patients with IgA nephropathy and their correlations with clinical and pathological parameters

摘要:

摘要：目的  探讨免疫球蛋白A（IgA）肾病肾活检组织中骨桥蛋白（OPN）、转化生长因子-β1（TGF-β1）的表达及其与临床指标及组织病理的关系。方法  应用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连接法测定60例IgA患者，30例微小病变肾病（MCD）患者及20例正常肾组织肾组织中OPN、TGF-β1。同时测定各组血肌酐、肌酐清除率、24 h尿蛋白定量水平，应用Haas分型标准和Katafuchi分级对IgA患者进行病理评价，并分析肾组织OPN、TGF-β1与临床指标及病理的关系。结果  IgA肾病组Haas各分型（Ⅰ～Ⅴ型）血肌酐、24 h尿蛋白定量及肾组织中OPN、TGF-β1表达水平高于MCD对照组和健康对照组（P <0.05），而肌酐清除率低于MCD对照组和健康对照组（P <0.05），其中Haas分型中Ⅳ和Ⅴ型肾组织中OPN、TGF-β1表达高于Ι、Ⅱ和Ⅲ型（P <0.05）。IgA肾病组Katafuchi分级（0～Ⅲ级）血肌酐、24 h尿蛋白定量及肾组织中OPN、TGF-β1表达水平高于MCD对照组和健康对照组（P <0.05），肌酐清除率低于MCD对照组和健康对照组（P <0.05）。随着Katafuchi分级增加，IgA肾组织中OPN、TGF-β1表达水平升高（P <0.05）。经Spearman相关分析，IgA患者Haas分型、Katafuchi分级与肾组织中OPN、TGF-β1、24 h尿蛋白定量呈正相关（P <0.05）。结论  OPN、TGF-β1参与IgA肾病肾小管间质损伤病理过程，是引起IgA肾病病情恶化的重要因素之一。

Abstract:

Abstract: Objective To investigate the expressions of osteopontin (OPN) and transforming growth factor-β1 (TGF-β1) in renal biopsy tissue of IgA nephropathy and their relationships with clinicopathological parameters.Methods The levels of OPN and TGF-β1 in the renal tissues of 60 cases of IgA nephropathy, 30 cases of minimal change nephropathy (MCD) and 20 people with normal kidneys were detected with immunohistochemical SP method. Serum creatinine, creatinine clearance and 24-h urinary protein were determined. Haas typing and Katafuchi grading were used to evaluate the pathological changes of IgA  nephropathy patients. The correlations of OPN and TGF-β1 in renal tissues with clinical parameters and pathological changes were analyzed. Results The levels of serum creatinine and 24-h urinary protein, and the expressions of OPN and TGF-β1 in the IgA nephropathy group of Haas type Ⅰ-Ⅴ were higher than those in the MCD control group and the healthy control group, but the creatinine clearance was lower than that in the MCD and healthy control groups (P < 0.05). The expressions of OPN and TGF-β1 in the type Ⅳ and Ⅴ renal tissues were significantly higher than those in the type Ⅰ, Ⅱ and Ⅲ renal tissues (P < 0.05). The levels of serum creatinine and 24-h urinary protein and the expressions of OPN and TGF-β1 in the IgA nephropathy group of Katafuchi grade 0-Ⅲ were higher than those in the MCD control group and the healthy control group, while the creatinine clearance was lower than that in the MCD and healthy control groups(P < 0.05). The expressions of OPN and TGF-β1 in the renal tissue of IgA nephropathy group significantly rose with the increase of Katafuchi grade (P < 0.05). The Spearman correlation analysis showed that Haas type and Katafuchi grade were in positive correlations with OPN and TGF-β1 levels in the renal tissues and 24-h urinary protein in the IgA nephropathy patients (P < 0.05). Conclusions OPN and TGF-β1 may play important roles in the pathogenesis of IgA nephropathy and renal tubulointerstitial injury.