Center for Autoimmunity and Musculoskeletal Diseases, Feinstein Institute for Medical Research, Manhasset, New York, NY 11030.
Department of Internal Medicine, Nephrology, University of Michigan, Ann Arbor, MI 48109.
Arthritis Rheumatol. 2014 Aug;66(8):2246-2258. doi: 10.1002/art.38679.
To elucidate the molecular mechanisms involved in renal inflammation during the progression, remission, and relapse of nephritis in murine lupus models using transcriptome analysis.
Kidneys from (NZB × NZW)F1 (NZB/NZW) and NZM2410 mice were harvested at intervals during the disease course or after remission induction. Genome-wide expression profiles were obtained from microarray analysis of perfused kidneys. Real-time polymerase chain reaction (PCR) analysis for selected genes was used to validate the microarray data. Comparisons between groups using SAM, and unbiased analysis of the entire data set using singular value decomposition and self-organizing maps were performed.
Few changes in the renal molecular profile were detected in prenephritic kidneys, but a significant shift in gene expression, reflecting inflammatory cell infiltration and complement activation, occurred at proteinuria onset. Subsequent changes in gene expression predominantly affected mitochondrial dysfunction and metabolic stress pathways. Endothelial cell activation, tissue remodeling, and tubular damage were the major pathways associated with loss of renal function. Remission induction reversed most, but not all, of the inflammatory changes, and progression toward relapse was associated with recurrence of inflammation, mitochondrial dysfunction, and metabolic stress signatures.
Immune cell infiltration and activation is associated with proteinuria onset and is reversed by immunosuppressive therapy, but disease progression is associated with renal hypoxia and metabolic stress. Optimal therapy for lupus nephritis may therefore need to target both immune and nonimmune disease mechanisms. In addition, the overlap of a substantial subset of molecular markers with those expressed in the kidneys of lupus patients suggests potential new biomarkers and therapeutic targets.
通过转录组分析阐明在狼疮模型小鼠肾炎进展、缓解和复发过程中肾脏炎症相关的分子机制。
在疾病过程中或缓解诱导后,从 (NZB×NZW)F1 (NZB/NZW) 和 NZM2410 小鼠中收获肾脏。通过灌注肾脏的微阵列分析获得全基因组表达谱。使用实时聚合酶链反应 (PCR) 分析对选定基因进行分析,以验证微阵列数据。使用 SAM 进行组间比较,使用奇异值分解和自组织图对整个数据集进行无偏分析。
在肾炎前肾脏中检测到很少的肾脏分子谱变化,但在蛋白尿发病时发生了显著的基因表达变化,反映了炎症细胞浸润和补体激活。随后的基因表达变化主要影响线粒体功能障碍和代谢应激途径。内皮细胞激活、组织重塑和管状损伤是与肾功能丧失相关的主要途径。缓解诱导逆转了大多数炎症变化,但不是全部,而向复发进展与炎症、线粒体功能障碍和代谢应激特征的复发有关。
免疫细胞浸润和激活与蛋白尿发病有关,免疫抑制治疗可逆转,但疾病进展与肾脏缺氧和代谢应激有关。因此,狼疮肾炎的最佳治疗可能需要针对免疫和非免疫疾病机制。此外,大量分子标志物与狼疮患者肾脏中表达的标志物重叠,提示可能存在新的生物标志物和治疗靶点。