Okubo S
Department of Pediatrics, Niigata University School of Medicine, Japan.
Nihon Jinzo Gakkai Shi. 1995 Jul;37(7):357-65.
The existence of podocalyxin (PCX) in urine sediments of 30 children with IgA nephropathy was identified by positive findings of immunofluorescence testing using a monoclonal antibody (PHM-5). Three structures (cells (podocytes), casts, granules) were stained and arbitrarily scored according to their numbers and intensity of fluorescence. The urinary scores for podocytes and casts were higher in the acute stage than in the chronic stage (p < 0.02 and p < 0.01, respectively). Protein excretion and hematuria showed a strong parallel correlation in the podocytes (p < 0.005 and p < 0.001), and in the casts (p < 0.001 and p < 0.005) in the urine sediments. The urinary scores for podocytes and casts were significantly higher in cases with extracapillary lesions (p < 0.003 and p < 0.01) and with interstitial lesions (p < 0.02 and p < 0.008) but no correlation existed with the intensity of mesangial proliferation. The urinary scores for podocytes and casts were also higher in cases with mesangiocapillary IgA deposits (p < 0.04 and p < 0.04) and C 3 deposits (p < 0.03 and p < 0.04). These findings suggest that PCX in the urine sediments indicate the degree of the glomerular epithelial cell injury and is useful for clinical evaluations.
使用单克隆抗体(PHM - 5)进行免疫荧光检测,结果呈阳性,从而确定了30例IgA肾病患儿尿沉渣中足细胞标记蛋白(PCX)的存在。根据三种结构(细胞(足细胞)、管型、颗粒)的数量和荧光强度进行染色并任意评分。足细胞和管型的尿评分在急性期高于慢性期(分别为p < 0.02和p < 0.01)。尿沉渣中足细胞和管型的蛋白质排泄与血尿呈强平行相关性(分别为p < 0.005和p < 0.001,以及p < 0.001和p < 0.005)。毛细血管外病变(p < 0.003和p < 0.01)和间质病变(p < 0.02和p < 0.008)患儿的足细胞和管型尿评分显著更高,但与系膜增生强度无关。系膜毛细血管性IgA沉积(p < 0.04和p < 0.04)和C3沉积(p < 0.03和p < 0.04)患儿的足细胞和管型尿评分也更高。这些发现表明,尿沉渣中的PCX可指示肾小球上皮细胞损伤程度,对临床评估有帮助。