Yard B A, Kahlert S, Engelleiter R, Resch S, Waldherr R, Groffen A J, van den Heuvel L P, van der Born J, Berden J H, Kröger S, Hafner M, van der Woude F J
V. Medizinische Universitätsklinik, Klinikum Mannheim, University of Heidelberg, Heidelberg, Germany.
Exp Nephrol. 2001;9(3):214-22. doi: 10.1159/000052614.
A decrease in glomerular heparan sulfate (HS) proteoglycan (PG), without apparent decrease in HSPG core protein expression, has been reported to occur in diabetic nephropathy (DN). In most studies however, agrin, the major HSPG core protein in the glomerular basement membrane, has not been studied. This prompted us to study the glomerular expression of agrin in parallel to the expression of HS-glycosaminoglycans (GAG) in biopsies of patients with DN. Furthermore, the influence of glucose on agrin production in cultured podocytes and the expression of agrin in fetal kidneys was investigated.
Cryostat sections of renal biopsies from patients with DN (n = 8) and healthy controls (HC, n = 8), were stained for agrin and HS-GAG. Sections of fetal kidneys were double stained for agrin and CD35 or CD31. Stainings were performed by indirect immunofluorescence (IIF). The production of agrin by cultured human podocytes was tested by ELISA and IIF.
The expression of agrin, detected by AS46, was significantly reduced in biopsies from patients with DN compared to HC (p < 0.01). Similar findings were observed when monoclonal antibody JM72 was used (p < 0.05). In addition, a significant reduction in the glomerular expression of HS-GAG was detected with JM403 in these patients (p < 0.01). Agrin is expressed in cultured podocytes, the expression hereof was reduced when the cells were cultured in the presence of 25 mM D-glucose (p < 0.01). In biopsies of human fetal kidneys, glomerular expression of agrin coincided with the expression of CD31. In early stages of glomerular differentiation there was a strong staining for agrin and CD31 while CD35 was only slightly positive.
Our data argue against a selective dysregulation in HSPG sulfation in DN, but suggest a pivotal role for hyperglycemia in the downregulation of agrin core protein production.
据报道,糖尿病肾病(DN)患者肾小球硫酸乙酰肝素(HS)蛋白聚糖(PG)减少,而HSPG核心蛋白表达无明显降低。然而,在大多数研究中,尚未对肾小球基底膜中的主要HSPG核心蛋白集聚蛋白聚糖进行研究。这促使我们在DN患者活检中,并行研究集聚蛋白聚糖的肾小球表达与HS-糖胺聚糖(GAG)的表达。此外,还研究了葡萄糖对培养的足细胞中集聚蛋白聚糖产生的影响以及其在胎儿肾脏中的表达。
对DN患者(n = 8)和健康对照者(HC,n = 8)的肾活检组织进行冰冻切片,用集聚蛋白聚糖和HS-GAG染色。胎儿肾脏切片用集聚蛋白聚糖和CD35或CD31进行双重染色。染色采用间接免疫荧光法(IIF)。通过ELISA和IIF检测培养的人足细胞中集聚蛋白聚糖的产生。
与HC相比,DN患者活检组织中通过AS46检测到的集聚蛋白聚糖表达显著降低(p < 0.01)。使用单克隆抗体JM72时也观察到类似结果(p < 0.05)。此外,用JM403检测发现这些患者的肾小球HS-GAG表达显著降低(p < 0.01)。集聚蛋白聚糖在培养的足细胞中表达,当细胞在25 mM D-葡萄糖存在下培养时,其表达降低(p < 0.01)。在人胎儿肾脏活检组织中,肾小球集聚蛋白聚糖表达与CD31表达一致。在肾小球分化早期,集聚蛋白聚糖和CD31染色强烈,而CD35仅呈弱阳性。
我们的数据不支持DN中HSPG硫酸化存在选择性失调,但提示高血糖在集聚蛋白聚糖核心蛋白产生下调中起关键作用。