Department of Nephrology, Taizhou Hospital, Wenzhou Medical University, Linhai 317000, Zhejiang Province, China; National Clinical Research Center of Kidney Diseases, Jingling Hospital, Nanjing University School of Medicine, Nanjing 210002, Jiangsu Province, China.
Department of Pediatrics, Jingling Hospital, Nanjing University School of Medicine, Nanjing 210002, Jiangsu Province, China.
Clin Chim Acta. 2018 Jul;482:65-73. doi: 10.1016/j.cca.2018.03.033. Epub 2018 Mar 28.
Complement has been suggested to be involved in diabetic nephropathy (DN), but the exact significance and underlying mechanisms remain unclear. Data about renal local complement activation in DN patients is scarce. The purpose of the study was to clarify the significance and mechanism of renal local complement activation in DN.
Sixty-two biopsy-proven DN patients were recruited. Renal expression of C1Q, factor B, C5b-9, MBL and MBL-associated serine protease 1 (MASP1) were detected and associated with the kidney damage.
C5b-9, MBL and MASP1 was found to increase with the progression of DN. Especially, the level of C5b-9, MBL and MASP1 in tubular interstitium was closely associated with the damage degree of tubular interstitium. In addition, MBL and MASP1 co-localized and their levels in tubular interstitium correlated with the levels of C5b-9 in tubules and tubular interstitium.
Increased renal local complement activation was present in DN patients and might contribute to the kidney damage, especially tubular interstitial damage. MBL pathway might play an important role in renal tubular interstitial complement activation. Methods against complement activation or MBL pathway might be effective in reducing renal tubular interstitial damage in DN patients.
补体被认为与糖尿病肾病(DN)有关,但确切的意义和潜在机制仍不清楚。关于 DN 患者肾脏局部补体激活的数据很少。本研究旨在阐明 DN 中肾脏局部补体激活的意义和机制。
纳入 62 例经活检证实的 DN 患者。检测肾组织中 C1Q、因子 B、C5b-9、MBL 和 MBL 相关丝氨酸蛋白酶 1(MASP1)的表达,并与肾脏损伤相关。
C5b-9、MBL 和 MASP1 的表达随着 DN 的进展而增加。特别是,C5b-9、MBL 和 MASP1 在肾小管间质中的水平与肾小管间质的损伤程度密切相关。此外,MBL 和 MASP1 共定位,其在肾小管间质中的水平与肾小管和肾小管间质中 C5b-9 的水平相关。
DN 患者存在肾脏局部补体激活增加,可能导致肾脏损伤,特别是肾小管间质损伤。MBL 途径可能在肾脏肾小管间质补体激活中起重要作用。针对补体激活或 MBL 途径的方法可能有助于减少 DN 患者的肾小管间质损伤。