Wang Nian-Song, Wu Zhao-Long, Zhang Yue-E, Liao Lu-Tan
Department of Nephrology, the Sixth Affiliated Hospital of Shanghai Jiaotong University, 600 Yushan Road, Shanghai 200233, China.
World J Gastroenterol. 2005 Feb 7;11(5):712-6. doi: 10.3748/wjg.v11.i5.712.
To investigate the existence and significance of hepatitis B virus (HBV) DNA in the pathogenesis of IgA nephropathy (IgAN).
Fifty cases of IgAN with HBV antigenaemia and/or hepatitis B virus antigens (HBAg, or HBsAg, HBcAg) detected by immunohistochemistry in renal tissues were enrolled in our study. The distribution and localization of HBV DNA were observed using in situ hybridization. Southern blot analysis was performed to reveal the state of renal HBV DNA.
Among the 50 patients with IgAN, HBs antigenemia was detected in 17 patients (34%). HBAg in renal tissues was detected in 48 patients (96%), the positive rate of HBAg, HBsAg, and HBcAg was 82% (41/50), 58% (29/50), and 42% (21/50) in glomeruli, respectively; and was 94% (47/50), 56% (28/50) and 78% (39/50) in tubular epithelia, respectively. Positive HBV DNA was detected in 72% (36/50) and 82% (41/50) cases in tubular epithelia and glomeruli respectively by in situ hybridization, and the positive signals were localized in the nuclei of tubular epithelial cells and glomerular mesangial cells as well as infiltrated interstitial lymphocytes. Moreover, 68% (34/50) cases were proved to be HBV DNA positive by Southern blot analysis, and all were the integrated form.
HBV infection might play an important role in occurrence and progress of IgAN. In addition to humoral immune damages mediated by HBAg-HBAb immune complex, renal tissues of some IgAN are directly infected with HBV and express HBAg in situ, and the cellular mechanism mediated by HBV originating from renal cells in situ may also be involved in the pathogenesis of IgAN.
探讨乙型肝炎病毒（HBV）DNA在IgA肾病（IgAN）发病机制中的存在情况及意义。
选取50例肾组织免疫组化检测出HBV抗原血症和/或乙肝病毒抗原（HBAg，即HBsAg、HBcAg）的IgAN患者纳入本研究。采用原位杂交观察HBV DNA的分布及定位。进行Southern印迹分析以揭示肾脏HBV DNA的状态。
50例IgAN患者中，17例（34%）检测到HBs抗原血症。48例（96%）肾组织检测到HBAg，肾小球中HBAg、HBsAg和HBcAg的阳性率分别为82%（41/50）、58%（29/50）和42%（21/50）；肾小管上皮中分别为94%（47/50）、56%（28/50）和78%（39/50）。原位杂交显示，肾小管上皮和肾小球中分别有72%（36/50）和82%（41/50）的病例HBV DNA呈阳性，阳性信号定位于肾小管上皮细胞、肾小球系膜细胞及浸润的间质淋巴细胞的细胞核中。此外，Southern印迹分析证实68%（34/50）的病例HBV DNA呈阳性，且均为整合形式。
HBV感染可能在IgAN的发生和发展中起重要作用。除了HBAg - HBAb免疫复合物介导的体液免疫损伤外，部分IgAN的肾组织直接感染HBV并原位表达HBAg，源自肾细胞原位的HBV介导的细胞机制也可能参与IgAN的发病机制。
