骨桥蛋白与糖尿病肾病关系的研究进展

骨桥蛋白(OPN)是一种具有细胞粘附和迁移功能的分泌型磷酸化糖蛋白。在肾脏中有广泛分布,研究发现其参与糖尿病肾病(DN)蛋白尿形成、DN的炎症反应及肾脏纤维化过程,抑制OPN可改善糖尿病肾脏病变。     

活性氧簇对蛋白尿的影响

蛋白尿不仅反映肾小球损伤,而且是一个独立的导致肾脏病变进展的主要因素,任何能够使蛋白尿减少的治疗干预都有利于减慢肾脏疾病的进展,遗传性蛋白尿性肾病是由于基因突变所致,获得性肾病大量蛋白尿成因目前尚未阐明。免疫异常,炎症介质及氧化应激反应均可导致肾损伤。氧自由基是肾损伤的主要介质,它作为强氧化剂是造成蛋白尿的重要原因之一。活性氧分子(ROS)可以通过降解肾小球乙酰肝素硫酸盐、肾小球基底膜Ⅳ型胶原富含赖氨酸的NCl区域发生交联、损伤足细胞破坏肾小球滤过屏障及与其他活性因子作用增强血清蛋白的渗透性等作用,造成蛋白尿。本文就近年来人们对活性氧造成蛋白尿的机制的研究做一综述,便于帮助医务工作者更好的了解和治疗蛋白尿性肾病。     

骨桥蛋白与糖尿病肾病关系的研究进展

骨桥蛋白（OPN）是一种具有细胞粘附和迁移功能的分泌型磷酸化糖蛋白。在肾脏中有广泛分布,研究发现其参与糖尿病肾病（DN）蛋白尿形成、DN的炎症反应及肾脏纤维化过程,抑制OPN可改善糖尿病肾脏病变。     

糖尿病肾病致凝血异常的研究

糖尿病(DM)已成为世界性的常见病,其发病率高,并且随着生活水平的改善,其发病率必然还会进一步加剧。血管病变是DM的重要并发症之一,糖尿病肾病(DN)是糖尿病常见且严重的微血管并发症,与血栓形成密切相关。糖尿病肾病的进展伴随着体内凝血活性和抗凝活性的失调,同时激活自身免疫系统,发生炎症反应。炎症应答过程中释放的炎症因子损伤肾小球内皮细胞,导致抗凝活性减弱。DN患者体内血细胞激活,微粒形成增多会加强凝血活性。此外,纤溶酶抑制剂(PAI-1)与纤溶酶激活剂(t PA)的失衡会引起纤溶系统紊乱。这三个方面引起DN患者体内的高凝状态加重,并因此加速肾功能恶化,导致肾小球率过滤降低,系膜基质增多,最终引起肾小球硬化及终末期肾脏疾病。本文就糖尿病肾病致凝血异常的发生机制做一综述。     

PIII 改性ePTFE 膜对细菌生存状态的影响研究

目的:探讨等离子注入技术(Plasma immersion ion implantation,PⅢ)对膨体聚四氟乙烯(ePTFE)膜改性后表面性能以及对细菌生存状态的影响.方法:采用氧等离子注入技术(PⅢ)对ePTFE膜表面处理,获得改性ePTFE膜,利用扫描电镜(SEM)观察改性ePTFE膜和未处理膜的表面形貌,体外培养变形链球菌,观察改性前后各组膜作体外细菌生存状态变化.结果:与未处理ePTFE膜相比,改性ePTFE膜表面形貌、亲水性发生改变.荧光染色后观察长脉冲组表面的细菌最少;短脉冲组膜表面粘附的细菌密集,形成生物膜;空白组可见少量死菌和活菌粘附于ePTFE膜上.结论:长脉冲PⅢ改性ePTFE膜后有良好的抗细菌粘附能力.     

糖尿病肾病蛋白尿发生机制的研究进展

糖尿病肾病蛋白尿的发生发展是多因素综合作用的结果.虽然蛋白尿的确切病因仍未清楚,但基本是由肾脏血流动力学改变、肾小球滤过屏障异常、多种生长因子、细胞因子、免疫炎症因子异常表达以及肾小管异常等多个因素综合所致.在分子水平上,氧化应激是糖尿病并发症发生的早期事件.此外,内皮细胞结构异常和功能紊乱以及肾小管重吸收功能异常可能也参与了蛋白尿的发生发展.本文着重探讨糖尿病肾病蛋白尿发生的细胞及分子机制研究进展,为更好的防治糖尿病肾病提供有力的依据.     

顺反式肉桂醛对肉源隆德假单胞菌生物被膜和致腐性的抑制作用

【目的】为比较反式和顺式肉桂醛对肉源假单胞菌生物被膜和致腐性的影响。【方法】通过平板计数测定两种肉桂醛对隆德假单胞菌的最小抑菌浓度(MIC),结晶紫法、珠涡流法、激光共聚焦显微镜观察、福林法等检测亚抑菌浓度肉桂醛处理下隆德假单胞菌生物被膜形成、运动性和胞外酶活性变化。荧光定量RT-PCR检测肉桂醛对隆德假单胞菌粘附lapA、鞭毛fliC、蛋白酶aprX和脂肪酶lip基因表达量的影响。【结果】反式和顺式肉桂醛对隆德假单胞菌的MIC分别为200μg/mL和225μg/mL,1/8 MIC、1/4MIC、1/2MIC亚抑菌浓度肉桂醛显著降低隆德假单胞菌生物被膜结晶紫和粘附性,其中1/2MIC反式和顺式肉桂醛处理下被膜分别减少60.27%和52.05%,菌体粘附降低56.35%和61.10%。亚抑菌浓度肉桂醛显著减少被膜厚度,反式肉桂醛还能显著杀灭被膜菌。且肉桂醛能显著抑制菌体的泳动性,反式肉桂醛对生物被膜和泳动性的抑制效果更强。肉桂醛还能抑制隆德假单胞菌蛋白酶和脂肪酶活性,其中1/2MIC反式和顺式肉桂醛处理下菌体蛋白酶分别减少61.90%和76.19%,脂肪酶降低40.17%和47.01%。且发现肉桂醛显著降低lapA、fliC、aprX和lip表达量,其中1/2MIC反式和顺式肉桂醛分别降低4个基因表达量至对照组的0.05–0.16和0.02–0.12倍。【结论】两种亚抑菌浓度肉桂醛异构体显著抑制隆德假单胞菌生物被膜和致腐性,其中反式肉桂醛对生物被膜抑制较强,而顺式肉桂醛更有效地降低致腐酶活性,其与肉桂醛下调相应基因表达密切相关。     

亚适宜温光盐环境下油菜素内酯对黄瓜幼苗抗氧化系统及光合作用的影响

研究了24 表油菜素内酯(EBR)对亚适宜温光盐环境下黄瓜幼苗抗氧化系统及光合作用的影响.结果表明: 与对照相比,亚适宜温光盐环境下黄瓜幼苗叶片H₂O₂含量增加,膜脂过氧化程度加剧,膜透性增强,净光合速率(P_n)、气孔导度(g_s)、胞间CO₂浓度(C_i)和蒸腾速率(T_r)分别显著下降39.3%、40.0%、21.2%和47.2%,幼苗干物质积累减少35.9%.外源喷施EBR可提高亚适宜温光盐环境下黄瓜幼苗的抗氧化酶活性,降低H₂O₂含量及膜透性,缓解亚适宜温光盐环境下P_n、g_s、T_r的下降幅度,幼苗干物质积累增加25.9%,生长加快．EBR可通过调节亚适宜温光盐环境下黄瓜幼苗抗氧化性,减少其膜脂过氧化程度,进而维持其较高的光合性能,有效促进了亚适宜温光盐环境下黄瓜幼苗的生长．     

一种用于观察纤毛虫表膜下结构的扫描电镜样品制备新方法

该实验摸索出通过扫描电镜观察纤毛虫表膜下三维结构的新方法:用适当浓度的KMnO_4作为固定剂,固定虫体细胞表膜,调整固定液的渗透压使细胞在低渗溶液中胀破、细胞质溶出,表膜剥落下来、内外翻转,经脱水、冷冻干燥、喷金后,在扫描电镜下对爽口虫(Climacostomumsp.)、尾草履虫(Paramecium caudatum)及拟尾柱虫(Paraurostyla weissei)的表膜下结构进行了观察。结果表明:利用此方法能够观察到表膜下层次分明而又清晰的三维立体构象。此方法可为纤毛虫表膜及其它细胞质膜的研究提供可借鉴的样品制备新方法。     

衰变加速因子——补体激活途径中的一个膜调节蛋白

衰变加速因子(DAF)是补体激活途径中的一个重要膜调节蛋白。主要存在于红细胞、粒细胞、单核细胞、淋巴细胞及血小板表面上。能阻止两条途径C3及C5转化酶的装配并加速其衰变。在C3及C5转化酶的调控中起到了中心作用。其缺乏与疾病——阵发性睡眠性血红蛋白尿(PNH)有密切关系。     

Complement inhibitors targeted to the proximal tubule prevent injury in experimental nephrotic syndrome and demonstrate a key role for C5b-9

In glomerular diseases of diverse etiologies, dysfunction of the glomerular barrier to protein passage results in proteinuria, and proteinuria is considered an independent risk factor that plays a direct role in inflammation, interstitial fibrosis, and renal failure. The mechanism by which proteinuria leads to nephrotoxic injury is unclear, but a role for complement in mediating interstitial damage appears likely. We describe a strategy for Ag-specific targeting of complement inhibitors using a single chain Ab fragment and show that complement inhibitors targeted to the tubular epithelium protect against tubulointerstitial injury and renal dysfunction in a rat model of puromycin-induced nephrosis. The targeting of systemically administered complement inhibitors markedly enhanced their efficacy and obviated the need to systemically inhibit complement, thus reducing the risk of compromising host defense and immune homeostasis. Targeted inhibition of complement activation by Crry, and of membrane attack complex (MAC) formation by CD59 was equally therapeutic, demonstrating that the MAC plays a key role in proteinuria-induced tubulointerstitial injury. CD59 activity was dependent on its being targeted to the site of complement activation, and this is the first report of specific inhibition of the MAC in vivo after systemic administration of inhibitor. The data establish the MAC is a valid target for pharmaceutical intervention in proteinuric disorders and provide an approach to investigate the role of the MAC in complement-dependent disease under clinically relevant conditions.     

The membrane attack complex in complement-mediated glomerular epithelial cell injury: formation and stability of C5b-9 and C5b-7 in rat membranous nephropathy

Using a model of rat membranous nephropathy (MN), we examined the relationship between the development of glomerular epithelial cell injury and the formation and stability of the membrane attack complex (MAC) of complement. Isolated rat kidneys were perfused with buffered bovine albumin (BSA) or various plasmas (complement source). Kidneys containing nephritogenic amounts of complement-fixing sheep antibody to glomerular epithelial antigens (aFx1A) perfused with BSA (n = 5), and normal kidneys perfused with normal human plasma in BSA (50% v/v, n = 6) excreted 0.30 +/- 0.02 mg protein/min/g during 90 min perfusion (control groups). When normal plasma was added to the perfusate of aFx1A kidneys at concentrations of 12.5, 25, and 50% v/v, protein excretion rose in a time- and concentration-dependent manner. Perfusions with 25% plasma resulted in baseline proteinuria from 0 to 20 min that increased to 2.8 +/- 0.9 mg/min/g at 20 to 40 min and 8.6 +/- 2.1 at 40 to 60 min (n = 4, p less than 0.01 vs control groups). Removal of plasma at 20 min did not prevent this rise in protein excretion (3.9 +/- 2.4 and 5.8 +/- 2.6 mg/min/g at 30 to 40 and 55 to 65 min respectively, p less than 0.01, n = 4). Perfusion of aFx1A kidneys with C8-deficient (C8D) human plasma (25% v/v, n = 4) or C6D rabbit serum (25% v/v, n = 2) independently produced low levels of proteinuria comparable with BSA, but in combination, the two reagents restored enhanced protein excretion (n = 2). In aFx1A kidneys containing C5b-7, addition of C8 and C9 (C6D serum) after intervals of 20, 60, or 90 min immediately reconstituted heavy proteinuria. Thus, the magnitude of MAC-induced glomerular epithelial injury in rat MN is related to the complement dose. Altered glomerular permeability is delayed with respect to the onset of complement activation. Once sufficient C5b-9 is formed, proteinuria can develop despite cessation of new MAC assembly, implying that C5b-9 persists after formation. Moreover, the C5b-7 MAC intermediate is not eliminated rapidly in this model.     

Nephrin phosphorylation regulates podocyte adhesion through the PINCH-1-ILK-α-parvin complex

Nephrin, a structural molecule, is also a signaling molecule after phosphorylation. Inhibition of nephrin phosphorylation is correlated with podocyte injury. The PINCH-1-ILK-α-parvin (PIP) complex plays a crucial role in cell adhesion and cytoskeleton formation. We hypothesized that nephrin phosphorylation influenced cytoskeleton and cell adhesion in podocytes by regulating the PIP complex. The nephrin phosphorylation, PIP complex formation, and F-actin in Wistar rats intraperitoneally injected with puromycin aminonucleoside were gradually decreased but increased with time, coinciding with the recovery from glomerular/podocyte injury and proteinuria. In cultured podocytes, PIP complex knockdown resulted in cytoskeleton reorganization and decreased cell adhesion and spreading. Nephrin and its phosphorylation were unaffected after PIP complex knockdown. Furthermore, inhibition of nephrin phosphorylation suppressed PIP complex expression, disorganized podocyte cytoskeleton, and decreased cell adhesion and spreading. These findings indicate that alterations in nephrin phosphorylation disorganize podocyte cytoskeleton and decrease cell adhesion through a PIP complex-dependent mechanism. [BMB Reports 2013; 46(4): 230-235]     

The activation of extracellular signal-regulated kinase is responsible for podocyte injury

Podocyte and its slit diaphragm play an important role in maintaining normal glomerular filtration barrier function and structure. Podocyte apoptosis and slit diaphragm injury leads to proteinuria and glomerulosclerosis. However, the molecular mechanism of podocyte injury remains poorly understood. The family of mitogen-activated protein kinases including extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase, and p38 signal pathways, are implicated in the progression of various glomerulopathies. However, the role of the activated signal pathway(s) in podocyte injury is elusive. This study examined phosphorylation of ERK in rat puromycin aminonucleoside (PAN) nephropathy as well as conditionally immortalized mouse podocyte treated with PAN in vitro. The effect of treatment with U0126, an inhibitor of ERK, was also investigated. In PAN nephropathy, the phosphorylation of ERK was marked. In podocyte injury, the marked and sustained activation of ERK pathway was also observed before the appearance of significant podocyte apoptosis. Pretreatment with U0126 to podocyte completely inhibited ERK activation, with complete suppression podocyte apoptosis and ameliorated nephrin protein expression along with the phosphorylation of nephrin in podocyte injury. In cultured podocyte, PAN induced actin recorganition, and U0126 inhibited such change. However, U0126 did not recovery the phosphorylation change of neph1 in podocyte injury. We concluded that the sustained activation of ERK along with the phosphorylation of neph1 might be necessary for podocyte injury. The study here suggested that ERK might become a potential target for therapeutic intervention to prevent podocytes from injury which will result in proteinuria.     

A derivative of the plasma protease inhibitor alpha(2)-macroglobulin regulates the response to peripheral nerve injury

Peripheral nerve injury induces endoneural inflammation, controlled by diverse cytokines and extracellular mediators. Although inflammation is coupled to axonal regeneration, fulminant inflammation may increase nerve damage and neuropathic pain. alpha(2)-Macroglobulin (alpha2M) is a plasma protease inhibitor, cytokine carrier, and ligand for cell-signaling receptors, which exists in two well-characterized conformations and in less well-characterized intermediate states. Previously, we generated an alpha2M derivative (alpha(2)-macroglobulin activated for cytokine binding; MAC) similar in structure to alpha(2)M conformational intermediates, which binds tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta), and inhibits endotoxin toxicity. In this study, we report that the continuum of cytokines that bind to MAC includes IL-6 and IL-18. MAC inhibited TNF-alpha-induced p38 mitogen-activated protein kinase activation and cell death in cultured Schwann cells. When administered by i.p. injection to mice with sciatic nerve crush injury, MAC decreased inflammation and preserved axons. Macrophage infiltration and TNF-alpha expression also are decreased. MAC inhibited TNF-alpha expression in the chronic constriction injury model of nerve injury. When MAC was prepared using a mutated recombinant alpha2M, which does not bind to the alpha2M receptor, low-density lipoprotein receptor-related protein-1, activity in the chronic constriction injury model was blocked. These studies demonstrate that an alpha2M derivative is capable of regulating the response to peripheral nerve injury by a mechanism that requires low-density lipoprotein receptor-related protein-1.     

New insights into mechanisms of immune glomerular injury.

Although glomerular disease remains the most common cause of end-stage renal disease worldwide, major advances have been made recently in understanding the cellular and molecular mechanisms that mediate these disorders. The nephrotic syndrome in noninflammatory lesions such as minimal change or focal sclerosis and membranous nephropathy results from disorders of the glomerular epithelial cell that can be simulated in animal models by antibodies to various epithelial cell membrane epitopes. Clarification of how these antibodies affect epithelial cells to induce a loss of glomerular barrier function should substantially improve understanding of the pathogenesis of minimal change or focal sclerosis. In membranous nephropathy, proteinuria is mediated primarily by the C5b-9 complex through similar mechanisms that also involve glomerular epithelial cells as targets. Inflammatory glomerular lesions are induced by circulating inflammatory cells or proliferating resident glomerular cells. Understanding of how these cells induce tissue injury has also evolved considerably over the past decade. Neutrophil-induced disease involves leukocyte adhesion molecules in regulating neutrophil localization; proteases, oxidants, and myeloperoxidase in mediating injury; and platelets in augmenting these processes. The activated mesangial cell exhibits altered phenotype and proliferation with the release of oxidants and proteases. Mesangial cell proliferation may be initiated by basic fibroblast growth factor and is maintained by an autocrine mechanism involving platelet-derived growth factor. Transforming growth factor beta is important in the subsequent development of sclerosis.     

Angiopoietin-Like-4, a Potential Target of Tacrolimus,Predicts Earlier Podocyte Injury in Minimal Change Disease

Podocyte injury plays central roles in proteinuria and kidney dysfunction, therefore, identifying specific biomarker to evaluate earlier podocyte injury is highly desirable. Podocyte-secreted angiopoietin-like-4 (Angptl4) mediates proteinuria in different types of podocytopathy. In the present study, we established an experimental minimal change disease (MCD) rat model, induced by adriamycin (ADR) and resulted in definite podocyte injury, to identify the dynamic changes in Angptl4 expression. We also investigated the direct effects of tacrolimus on Angptl4 and podocyte repair. We determined that the glomerular Angptl4 expression was rapidly upregulated and reached a peak earlier than desmin, an injured podocyte marker, in the ADR rats. Furthermore, this upregulation occurred prior to heavy proteinuria and was accompanied by increased urinary Angptl4. We observed that the Angptl4 upregulation occurred only when podocyte was mainly damaged since we didn’t observe little Angptl4 upregulation in MsPGN patients. In addition, we observed the glomerular Angptl4 mainly located in injured podocytes rather than normal podocytes. Moreover, we found that tacrolimus treatment significantly promoted podocyte repair and reduced glomerular and urinary Angptl4 expression at an earlier stage with a significant serum Angptl4 upregulation. And similar results were confirmed in MCD patients. In conclusion, this study represents the first investigation to demonstrate that Angptl4 can predict podocyte injury at earlier stages in MCD and the identification of earlier podocyte injury biomarkers could facilitate the prompt diagnosis and treatment of patients with podocytopathy, as well as determination of the prognosis and treatment efficacy in these diseases.     

Emerging role of podocyte autophagy in the progression of diabetic nephropathy

Glomerular podocytes are pivotal in maintaining glomerular filtration barrier function. As severe podocyte injury results in proteinuria in patients with diabetic nephropathy, determining the pathogenesis of podocyte injury may contribute to the development of new treatments. We recently showed that autophagy is involved in the pathogenesis of diabetes-related podocyte injury. Insufficient podocyte autophagy and podocyte loss are observed in diabetic patients with massive proteinuria. Podocyte loss and massive proteinuria occur in high-fat diet-induced diabetic mice with podocyte-specific autophagy deficiency, with podocytes of these mice and of diabetic rats having huge damaged lysosomes. Sera from diabetic patients and from rodents with massive proteinuria cause autophagy insufficiency, resulting in lysosome dysfunction and apoptosis of cultured podocytes. These findings suggest the importance of autophagy in maintaining lysosome homeostasis in podocytes under diabetic conditions. Impaired autophagy may be involved in the pathogenesis of podocyte loss, leading to massive proteinuria in diabetic nephropathy.     

Renoprotective effects of anti-TGF-β antibody and antihypertensive therapies in Dahl S rats

This study examined the effects of anti-TGF-β antibody (1D11) therapy in Dahl S (S) rats fed a 4% NaCl diet. Baseline renal expression of TGF-β1 and the degree of injury were lower in female than male S rats maintained on a 0.4% NaCl diet. 4% NaCl diet increased mean arterial pressure (MAP), proteinuria, and renal injury to the same extent in both male and female S rats. Chronic treatment with 1D11 had renoprotective effects in both sexes. The ability of 1D11 to oppose the development of proteinuria when given alone or in combination with antihypertensive agents was further studied in 6-wk-old female S rats, since baseline renal injury was less than that seen in male rats. 1D11, diltiazem, and hydrochlorothiazide (HCT) attenuated the development of hypertension, proteinuria, and glomerular injury. 1D11 had no additional effect when given in combination with these antihypertensive agents. We also explored whether 1D11 could reverse renal injury in 9-wk-old male S rats with preexisting renal injury. MAP increased to 197 ± 4 mmHg and proteinuria rose to >300 mg/day after 3 wk on a 4% NaCl diet. Proteinuria was reduced by 30-40% in rats treated with 1D11, HCT, or captopril + 1D11, but the protective effect was lost in rats fed the 4% NaCl diet for 6 wk. Nevertheless, 1D11, HCT, and captopril + 1D11 still reduced renomedullary and cardiac fibrosis. These results indicate that anti-TGF-β antibody therapy reduces renal and cardiac fibrosis and affords additional renoprotection when given in combination with various antihypertensive agents in Dahl S rats.