Hirata K, Shikata K, Matsuda M, Akiyama K, Sugimoto H, Kushiro M, Makino H
Department of Medicine III, Okayama University Medical School, Japan.
Diabetologia. 1998 Feb;41(2):185-92. doi: 10.1007/s001250050888.
In diabetic nephropathy leukocytes, mainly composed of monocytes/macrophages, which accumulate in the glomeruli and the interstitium, play an important part in the progression of glomerulosclerosis. The infiltration of leukocytes into inflammatory tissues or atherosclerotic lesions is mediated by adhesion molecules, which are expressed on the vascular endothelial cells, although little is known about the mechanism of leukocyte infiltration into diabetic renal tissues. P- and E-selectin are leukocyte adhesion molecules, which are expressed on the vascular endothelial cells and promote the adhesion of leukocytes to the endothelium. We investigated the expression of P- and E-selectin in the kidney tissue of patients with diabetic nephropathy and compared it with that of patients with other glomerular diseases (minimal change nephrotic syndrome, membranous nephropathy, IgA nephropathy, mesangioproliferative glomerulonephritis, and lupus nephritis). Expression of P- and E-selectin were both significantly increased in the glomeruli and the interstitium of patients with diabetic nephropathy as compared with those with other glomerular diseases. P- and E-selectin were both expressed along the glomerular capillaries and the peritubular capillaries in the interstitium. Neither P- nor E-selectin were correlated with the number of infiltrated leukocytes in the glomeruli, however, interestingly the E-selectin expression on peritubular capillaries was correlated with the number of infiltrated CD14 positive cells in the interstitium. These results suggest that E-selectin may play a key role in leukocyte infiltration into the renal interstitium in patients with diabetic nephropathy.
在糖尿病肾病中，主要由单核细胞/巨噬细胞组成的白细胞积聚在肾小球和间质中，在肾小球硬化的进展中起重要作用。白细胞浸润到炎症组织或动脉粥样硬化病变是由血管内皮细胞上表达的黏附分子介导的，尽管对白细胞浸润到糖尿病肾组织的机制知之甚少。P-选择素和E-选择素是白细胞黏附分子，它们在血管内皮细胞上表达并促进白细胞与内皮细胞的黏附。我们研究了糖尿病肾病患者肾组织中P-选择素和E-选择素的表达，并将其与其他肾小球疾病（微小病变肾病综合征、膜性肾病、IgA肾病、系膜增生性肾小球肾炎和狼疮性肾炎）患者的表达进行了比较。与其他肾小球疾病患者相比，糖尿病肾病患者肾小球和间质中P-选择素和E-选择素的表达均显著增加。P-选择素和E-选择素均沿肾小球毛细血管和间质中的肾小管周围毛细血管表达。P-选择素和E-选择素均与肾小球中浸润白细胞的数量无关，然而，有趣的是，肾小管周围毛细血管上的E-选择素表达与间质中浸润的CD14阳性细胞数量相关。这些结果表明，E-选择素可能在糖尿病肾病患者白细胞浸润到肾间质中起关键作用。
