Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung City 40705, Taiwan.
Lupus. 2013 May;22(6):554-61. doi: 10.1177/0961203313480398. Epub 2013 Mar 11.
Lupus nephritis (LN) is usually associated with widespread effacement of the podocytes' foot processes leading to proteinuria. Induction of urokinase receptor (uPAR) signaling in podocytes leads to foot process effacement and urinary protein loss via promoting podocytes' motility and kidney permeability in the glomerulus. Very little is known about uPAR signaling in LN. Mycophenolate mofetil (MMF), an immunosuppressive agent, efficiently modulates the development of LN in humans and mice, but there are no data concerning the direct uPAR involvement on podocytes in LN. The MMF efficiency and uPAR involvement signaling in NZB×NZW F1 lupus-prone mice were examined by proteinuria, renal function and pathology, immune complex deposits, and uPAR expression of podocytes by immunofluorescence staining and quantitative RT-PCR. After MMF treatment, the proteinuria (p < 0.01), BUN level (p < 0.05) and immunodeposition in glomeruli (p < 0.001) were significantly improved. Most important, the renal uPAR mRNA levels (p < 0.001) and uPAR protein level of podocytes (p < 0.001) were significantly reduced. The beneficial effect of MMF on LN could be attributed, at least in part, to the inhibition of uPAR expression in podocytes. These findings demonstrated uPAR could have potential as a predictive index for response to LN therapeutics.
狼疮性肾炎(LN)通常与广泛的足细胞足突消失有关,导致蛋白尿。尿激酶受体(uPAR)信号在足细胞中的诱导导致足突消失和尿蛋白丢失,这是通过促进肾小球中足细胞的运动和肾脏通透性来实现的。关于 LN 中的 uPAR 信号知之甚少。霉酚酸酯(MMF)是一种免疫抑制剂,能有效调节人类和小鼠 LN 的发展,但关于 MMF 对 LN 中足细胞的直接 uPAR 参与作用尚无数据。通过蛋白尿、肾功能和病理学、免疫复合物沉积以及免疫荧光染色和定量 RT-PCR 检测 uPAR 表达来检查 MMF 在 NZB×NZW F1 狼疮易感小鼠中的效率和 uPAR 参与信号。MMF 治疗后,蛋白尿(p<0.01)、BUN 水平(p<0.05)和肾小球免疫沉积(p<0.001)显著改善。最重要的是,肾脏 uPAR mRNA 水平(p<0.001)和足细胞 uPAR 蛋白水平(p<0.001)显著降低。MMF 对 LN 的有益作用至少部分归因于对足细胞中 uPAR 表达的抑制。这些发现表明 uPAR 可能成为预测 LN 治疗反应的一个潜在指标。