狼疮性肾炎患者肾组织中单核细胞趋化蛋白-1的表达与单核细胞募集及肾小管间质病变相关。

Monocyte chemoattractant protein-1 expression in renal tissue is associated with monocyte recruitment and tubulo-interstitial lesions in patients with lupus nephritis.

作者信息

Dai C, Liu Z, Zhou H, Li L

机构信息

Research Institute of Nephrology, Jinling Hospital, 305 East Zhongshan Road, Nanjing 210002, China.

出版信息

Chin Med J (Engl). 2001 Aug;114(8):864-8.

PMID:11780369

Abstract

OBJECTIVE

To investigate the pattern of monocyte chemoattractant prolein-1 (MCP-1) distribution in the renal interstitium and evaluate its pathogenic role in tubulo-interstitial lesions in patients with lupus nephritis, the distribution of MCP-1 in renal tissue was observed.

METHODS

Eighteen female patients with biopsy-proven lupus nephritis were enrolled in this study. No intensive immunosuppresive therapy was used in these patients during the 3 months prior to renal biopsy. The distribution of MCP-1, infiltration of CD68+ (macrophage/monocyte), CD4+ and CD8+ cells in the tubulo-interstitium of patients with lupus nephritis was detected using immunohistochemical staining with specific antibodies. Renal specimens from patients with minimal change glomerulonephritis were used as controls.

RESULTS

MCP-1 protein was widely distributed in the renal tissue of patients with lupus nephritis, mainly located at the baso-lateral surface of tubular epithelial cells (16/18 biopsies), and on the wall of interstitial blood vessels (9/18 biopsies). In contrast, tubular MCP-1 staining was weak and rare in renal tissue from controls (7.4 +/- 6.2% vs 26.7 +/- 22.8%, P < 0.01). Tubulo-interstitial infiltration of CD68+, CD4+ and CD8+ cells was markedly increased in patients with lupus nephritis as compared to controls. The tubular expression of MCP-1 was strongly associated with the amount of CD68+ cell infiltration in the interstitium (r = 0.5420, P < 0.05) and the extent of interstitial fibrosis. There was no correlation between MCP-1 production in tubules and the degree of urinary protein excretion in patients with lupus nephritis (r = 0.0547, P > 0.05).

CONCLUSIONS

The expression of MCP-1 in the renal tubules and vascular wall was markedly increased in patients with lupus nephritis. The overproduction of MCP-1 in renal tissue may contribute to monocyte recruitment in the interstitium and thus result in tubulo-interstitial damage in lupus nephritis.

摘要

目的

观察狼疮性肾炎患者肾组织中单核细胞趋化蛋白-1（MCP-1）的分布情况，探讨其在肾小管间质病变中的致病作用。

方法

选取18例经肾活检确诊的女性狼疮性肾炎患者，肾活检前3个月内未接受强化免疫抑制治疗。采用特异性抗体免疫组化染色法检测狼疮性肾炎患者肾小管间质中MCP-1的分布、CD68+（巨噬细胞/单核细胞）、CD4+和CD8+细胞的浸润情况。取微小病变性肾小球肾炎患者的肾组织作为对照。

结果

MCP-1蛋白在狼疮性肾炎患者肾组织中广泛分布，主要位于肾小管上皮细胞的基底外侧表面（16/18例活检标本）和间质血管壁（9/18例活检标本）。相比之下，对照组肾组织中肾小管MCP-1染色较弱且少见（7.4±6.2%对26.7±22.8%，P<0.01）。与对照组相比，狼疮性肾炎患者肾小管间质中CD68+、CD4+和CD8+细胞浸润明显增加。肾小管MCP-1的表达与间质中CD68+细胞浸润量（r=0.5420，P<0.05）和间质纤维化程度密切相关。狼疮性肾炎患者肾小管中MCP-1的产生与尿蛋白排泄程度无关（r=0.0547，P>0.05）。