Li Yue-hong, Huang Hai-chang, Liu Gang, Zhang You-kang
Department of Nephrology, Peking University First Hospital Peking University Institute of Nephrology, Beijing 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2004 Apr;36(2):135-8.
To address the significance of urinary podocytes in the diagnosis of human focal segmental glomerulosclerosis(FSGS).
Twelve patients with FSGS and 20 patients with minimal change disease (MCD) were diagnosed by routine renal biopsy, and 8 healthy persons as controls. Morning urinary sediments was collected and centrifuged onto glass slides. Urinary podocytes were identified by immunofluorescent staining of podocyte specific protein Podocalyxin(PCX). The state of podocytes in glomeruli was observed using immunofluorescence.
Urinary podocytes were found in 8 out of 12 FSGS patients(66.67%), whereas none of 20 patients with MCD and control had podocytes in their urine. FSGS patients with positives urinary podocytes had prominent manifestation of nephropathy syndrome, whereas no nephrotic syndrome in patients with negative urinary podocytes. Focal absence of the expression of PCX, a marker protein of podocytes in glomeruli was found in FSGS patients, and the locations of absence were consistent with the lesions of focal sclerosis in glomeruli. In contrast, PCX was expressed integrally in MCD patients.
Appearances of podocytes in urine of patients with nephropathy may be used as one of the reliable, convenient and unharmful accessorial methods for distinguished diagnosis of FSGS and MCD.
探讨尿足细胞在人类局灶节段性肾小球硬化症（FSGS）诊断中的意义。
通过常规肾活检诊断出12例FSGS患者和20例微小病变病（MCD）患者，8名健康人作为对照。收集晨尿沉淀物并离心到载玻片上。通过足细胞特异性蛋白Podocalyxin（PCX）的免疫荧光染色鉴定尿足细胞。使用免疫荧光观察肾小球中足细胞的状态。
12例FSGS患者中有8例（66.67%）发现尿足细胞，而20例MCD患者和对照组中无一例尿中出现足细胞。尿足细胞阳性的FSGS患者肾病综合征表现突出，而尿足细胞阴性的患者无肾病综合征。在FSGS患者中发现肾小球中足细胞标记蛋白PCX的表达局灶性缺失，缺失部位与肾小球局灶硬化病变一致。相比之下，PCX在MCD患者中表达完整。
肾病患者尿中足细胞的出现可作为鉴别诊断FSGS和MCD的可靠、便捷且无害的辅助方法之一。
