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急性肾小管间质性疾病患者中CD206阳性巨噬细胞的临床病理意义

Clinicopathological significance of CD206-positive macrophages in patients with acute tubulointerstitial disease.

作者信息

Li Jun, Liu Chang-Hua, Xu Dao-Liang, Gao Bo

机构信息

Department of Nephrology, Clinical Medical College, Yangzhou University Yangzhou 225001, Jiangsu, China.

出版信息

Int J Clin Exp Pathol. 2015 Sep 1;8(9):11386-92. eCollection 2015.

Abstract

OBJECTIVE

To investigate the clinicopathological significance of CD206-positive macrophage expression in patients with acute tubulointerstitial disease, including acute tubular necrosis (ATN) and acute interstitial nephritis (AIN).

METHODS

Renal tissue samples from patients with ATN (n=10), AIN (n=10), and minimal change disease (MCD, as disease control, n=8) as well as tissue from normal control kidneys (negative control, n=3) were included in this study. The expression of CD206 and CD68 in renal tissues was detected by immunohistochemistry or immunofluorescence.

RESULTS

CD206-positive cells accumulated in areas around damaged tubular cells and regenerating tubules. Compared with AIN patients, ATN patients had lower serum albumin, lower proteinuria, lower urinary osmolality and higher plasma hemoglobin, (P=0.002; P=0.01; P<0.001; P=0.002, respectively). CD206-positive cells could also be observed in the tubular basement membrane and tubule lumen. Some CD206-positive cells infiltrated into the tubular cells in patients with AIN. Compared to patients with ATN, patients with AIN had more CD206-positive cells (P=0.005). In the ATN patients, there were more CD206-positive cells in ischemic tissue. CD206-positive cells were negatively correlated with hemoglobin (r=-0.565, P=0.009) and positively correlated with serum albumin (r=0.496, P=0.026), urinary osmolality (r=0.567, P=0.009) and proteinuria (r=0.460, P=0.041). There was no correlation between CD206-positive cells and eGFR.

CONCLUSION

CD206-positive macrophages are involved in the pathogenesis of acute tubular necrosis and acute interstitial nephritis.

摘要

目的

探讨CD206阳性巨噬细胞在急性肾小管间质性疾病患者中的临床病理意义,包括急性肾小管坏死(ATN)和急性间质性肾炎(AIN)。

方法

本研究纳入了ATN患者(n = 10)、AIN患者(n = 10)、微小病变病(MCD,作为疾病对照,n = 8)以及正常对照肾脏组织(阴性对照,n = 3)的肾组织样本。通过免疫组织化学或免疫荧光检测肾组织中CD206和CD68的表达。

结果

CD206阳性细胞聚集在受损肾小管细胞和再生肾小管周围区域。与AIN患者相比,ATN患者血清白蛋白较低、蛋白尿较低、尿渗透压较低且血浆血红蛋白较高(分别为P = 0.002;P = 0.01;P < 0.001;P = 0.002)。在肾小管基底膜和肾小管腔内也可观察到CD206阳性细胞。在AIN患者中,一些CD206阳性细胞浸润到肾小管细胞中。与ATN患者相比,AIN患者的CD206阳性细胞更多(P = 0.005)。在ATN患者的缺血组织中,CD206阳性细胞更多。CD206阳性细胞与血红蛋白呈负相关(r = -0.565,P = 0.009),与血清白蛋白、尿渗透压和蛋白尿呈正相关(r分别为0.496,P = 0.026;r = 0.567,P = 0.009;r = 0.460,P = 0.041)。CD206阳性细胞与估算肾小球滤过率(eGFR)之间无相关性。

结论

CD206阳性巨噬细胞参与急性肾小管坏死和急性间质性肾炎的发病机制。

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