Sun Shiren, Zhao Ali, Li Rong, Du Rui, He Lijie, Sun Wenjuan, Wang Hanmin, Huang Chen
Department of Nephrology, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, China.
J Nephrol. 2015 Jun;28(3):307-14. doi: 10.1007/s40620-014-0161-1. Epub 2014 Dec 16.
BACKGROUND/AIMS: Recent studies have demonstrated that tubulointerstitial injury can predict renal outcomes better than the other histological parameters in patients with IgA nephropathy (IgAN). CD147 is a key regulator of renal tubulointerstitial fibrosis in cellular and animal models. However, it is not clear whether the expression of CD147 correlates with tubulointerstitial injury in IgAN patients.
We analyzed the degree of CD147 expression and localization in renal biopsy tissues from IgAN patients and correlated their immunostaining scores with clinical and histological parameters.
Elevated CD147 expression was found in the basolateral membrane of renal tubules in IgAN patients; however, in normal kidney samples, positive staining for CD147 was not found in the tubular epithelial cells (P = 0.000). CD147 protein expression in the renal tubules showed a negative correlation with estimated glomerular filtration rate (eGFR; r = -0.600, P = 0.000) and a positive correlation with serum creatinine (Scr; r = 0.322, P = 0.002) and tubulointerstitial lesions (r = 0.525, P = 0.000). Moreover, a high level of CD147 correlated with the activation of Slug expression and E-cadherin repression in patients with IgAN. Kaplan-Meier survival curves showed that elevated CD147 expression was associated with decreased renal survival. Multivariate analyses further demonstrated that a high CD147 immunostaining score was an independent predictor of renal outcome in patients with IgAN (HR = 8.731, P = 0.041).
CD147 expression is associated with tubulointerstitial injury and predicts renal prognosis in IgA nephropathy. CD147 may be an early marker for tubulointerstitial injury IgA nephropathy.
背景/目的：近期研究表明，在IgA肾病（IgAN）患者中，肾小管间质损伤比其他组织学参数能更好地预测肾脏预后。在细胞和动物模型中，CD147是肾小管间质纤维化的关键调节因子。然而，尚不清楚CD147的表达与IgAN患者的肾小管间质损伤是否相关。
我们分析了IgAN患者肾活检组织中CD147的表达程度和定位，并将其免疫染色评分与临床和组织学参数进行关联。
在IgAN患者肾小管的基底外侧膜中发现CD147表达升高；然而，在正常肾脏样本中，未在肾小管上皮细胞中发现CD147阳性染色（P = 0.000）。肾小管中CD147蛋白表达与估计肾小球滤过率呈负相关（eGFR；r = -0.600，P = 0.000），与血清肌酐（Scr；r = 0.322，P = 0.002）和肾小管间质病变呈正相关（r = 0.525，P = 0.000）。此外，IgAN患者中高水平的CD147与Slug表达的激活和E-钙黏蛋白的抑制相关。Kaplan-Meier生存曲线显示，CD147表达升高与肾脏生存率降低相关。多因素分析进一步表明，高CD147免疫染色评分是IgAN患者肾脏预后的独立预测因子（HR = 8.731，P = 0.041）。
CD147表达与肾小管间质损伤相关，并可预测IgA肾病的肾脏预后。CD147可能是IgA肾病肾小管间质损伤的早期标志物。
