Department of Rheumatology, Panyu Central Hospital, Guangzhou, China.
Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Lupus. 2021 Apr;30(4):560-567. doi: 10.1177/0961203320984231. Epub 2021 Jan 6.
We investigated the impact of estrogen receptor (ER) expression in renal tubular epithelial cells on serum uric acid (UA) levels in premenopausal patients with systemic lupus erythematosus (SLE). Thirty patients underwent renal biopsy: 18 with SLE (LN group) and 12 with IgA nephritis (IgAN group). ERs (ERα and ERβ) in renal tubular epithelial cells were measured using immunohistochemistry. The ER expression levels of the two groups were compared, and the relationship between the expression of ERs and serum UA levels was analyzed. Mean serum UA levels in the LN group were significantly higher than those of the IgA nephropathy group, while the mean creatinine levels and GFRs of the two groups were similar. Pathological changes in the LN group were significantly more severe than those in the IgAN group. ERβ was expressed in renal tubular epithelial cells in both groups, but not in the glomeruli. ERβ expression in the LN group was significantly lower than that in the IgAN group. ERβ expression scores significantly negatively correlated with serum UA levels. These findings suggest that the expression of ERβ in premenopausal female SLE patients may cause hyperuricemia, and may subsequently promote glomerular damage, suggesting that ERβ may be involved in UA excretion.
我们研究了绝经前系统性红斑狼疮（SLE）患者肾小管上皮细胞中雌激素受体（ER）表达对血清尿酸（UA）水平的影响。30 名患者接受了肾活检：18 名患有 SLE（LN 组）和 12 名患有 IgA 肾病（IgAN 组）。采用免疫组化法检测肾小管上皮细胞中的 ER（ERα 和 ERβ）。比较两组的 ER 表达水平，并分析 ERs 表达与血清 UA 水平之间的关系。LN 组的平均血清 UA 水平明显高于 IgA 肾病组，而两组的平均肌酐水平和 GFR 相似。LN 组的病理变化明显比 IgAN 组严重。两组的肾小管上皮细胞均表达 ERβ，但肾小球中不表达。LN 组的 ERβ 表达明显低于 IgAN 组。ERβ 表达评分与血清 UA 水平呈显著负相关。这些发现表明，绝经前女性 SLE 患者中 ERβ 的表达可能导致高尿酸血症，进而可能促进肾小球损伤，表明 ERβ 可能参与 UA 的排泄。
