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CD4+ T 淋巴细胞,尤其是 Th2 细胞,有助于肾纤维化的进展。

CD4+ T Lymphocytes, especially Th2 cells, contribute to the progress of renal fibrosis.

机构信息

Division of Nephrology, Department of Internal Medicine, Tongji Hospital, PR China.

出版信息

Am J Nephrol. 2012;36(4):386-96. doi: 10.1159/000343283. Epub 2012 Oct 9.

Abstract

BACKGROUND

Renal tubulointerstitial fibrosis is the final common stage of renal failure. CD4+ T lymphocyte recruitment and activation after injury could be the very important early event that mediates the onset of renal fibrogenesis. But the role of CD4+ T lymphocytes in renal fibrosis is controversial and its cellular mechanism needs to be further investigated.

METHODS

Biopsy specimens were from patients with minimal-change or IgA nephropathy. Mouse renal fibrosis was induced by unilateral ureteral obstruction (UUO). CD4+ T lymphocytes of wild BALB/c mice were depleted with anti-CD4 antibody. BALB/c Nu/Nu mice were reconstituted with polarized Th1 or Th2 cells by tail vein injection.

RESULTS

Our study demonstrated that massive CD4+ T lymphocytes infiltrated fibrotic kidneys of patients. The depletion of CD4+ T lymphocytes inhibited UUO-induced mouse renal fibrosis. In the process of UUO-induced renal fibrosis, the ratios of Th2/Th1 increased with time. Results have also shown that Th2-reconstituted mice developed renal fibrosis more easily than Th1-reconstituted mice, which manifested by interstitial expansion and collagen deposition, higher expression of α-SMA and vimentin and increased expression of fibronectin, TGF-β and collagen I. We also found that CD4+ T cells from Th1-reconstitued mice tended to secrete IL-4 and IL-13 Th2-like cytokines.

CONCLUSION

In conclusion, our study demonstrated the importance of CD4+ T lymphocytes in renal fibrosis and gave the first direct evidence that Th2 cells play a pivotal role in UUO-induced renal fibrosis. Inhibition of CD4+ T lymphocyte differentiation to Th2 would be a potential therapeutic intervention to prevent renal fibrosis.

摘要

背景

肾间质纤维化是肾功能衰竭的终末共同阶段。损伤后 CD4+T 淋巴细胞的募集和激活可能是介导肾纤维化发生的非常重要的早期事件。但是 CD4+T 淋巴细胞在肾纤维化中的作用存在争议,其细胞机制需要进一步研究。

方法

活检标本取自微小病变或 IgA 肾病患者。单侧输尿管梗阻(UUO)诱导小鼠肾纤维化。用抗 CD4 抗体耗竭野生 BALB/c 小鼠的 CD4+T 淋巴细胞。通过尾静脉注射将极化的 Th1 或 Th2 细胞重建到 BALB/c Nu/Nu 小鼠中。

结果

我们的研究表明,大量 CD4+T 淋巴细胞浸润纤维化肾脏。CD4+T 淋巴细胞耗竭抑制 UUO 诱导的小鼠肾纤维化。在 UUO 诱导的肾纤维化过程中,Th2/Th1 比值随时间增加。结果还表明,Th2 重建的小鼠比 Th1 重建的小鼠更容易发生肾纤维化,表现为间质扩张和胶原沉积,α-SMA 和波形蛋白表达增加,以及纤连蛋白、TGF-β 和胶原 I 表达增加。我们还发现,来自 Th1 重建小鼠的 CD4+T 细胞倾向于分泌 IL-4 和 IL-13 Th2 样细胞因子。

结论

综上所述,我们的研究表明 CD4+T 淋巴细胞在肾纤维化中的重要性,并首次直接证明 Th2 细胞在 UUO 诱导的肾纤维化中起关键作用。抑制 CD4+T 淋巴细胞向 Th2 分化可能是预防肾纤维化的潜在治疗干预措施。

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