I型纤溶酶原激活物抑制物在紫癜肾炎肾组织中的表达

为研究I型纤溶酶原激活物抑制物(PAI-1)在紫癜肾炎病理机制中的作用.采用免疫组织化学和原位杂交方法检测了23例紫癜肾炎患者肾组织中的PAI-1.结果证实:在正常肾组织内和紫癜肾炎肾组织内均可检测到PAI-1表达,PAI-1mRNA原位杂交阳性信号主要分布于血管平滑肌细胞和肾小管上皮细胞内,紫癜肾炎肾小球内有紫兰色阳性信号,且强度与肾小球内细胞的增生程度有关.     

原位杂交检测组织金属蛋白酶抑制因子-1mRNA在IgA肾病肾脏中的表达

为探讨组织蛋白酶抑制因子在 Ig A肾病肾小球硬化中的作用 ,本文用原位杂交法研究组织金属蛋白酶抑制因子 -1(TIMP- 1) m RNA在 3种类型 Ig A肾病 (轻度系膜增生型、中度系膜增生型及局灶型 )肾组织中的表达。结果表明 :TIMP-1m RNA原位杂交的阳性信号主要分布于部分肾小管上皮细胞内。在肾小球系膜细胞也可检测到 TIMP- 1m RNA阳性信号 ,但较肾小管弱。中度系膜增生型的 TIMP- 1m RNA阳性信号明显地较其他两型 Ig A肾病为强。以上结果表明 :由肾小管上皮细胞及系膜细胞合成的 TIMP- 1通过抑制基质金属蛋白酶的活性 ,可导致细胞外基质 (ECM)在肾小管间质及肾小球内过度沉积 ,从而对肾小球硬化有促进作用。     

原位杂交检测组织金属蛋白酶抑制因子—1 mRNA在IgA肾病肾脏中的表达

为探讨组织蛋白酶抑制因子在IgA肾病肾小球硬化中的作用。本文用原位杂交法研究组织金属蛋白酶抑制因子－1（TIMP－1）mRNA在3种类型IgA肾病（轻度系膜增生型、中度系膜增生型及局灶型）肾组织中的表达。结果表明：TIMP－1 mRNA原位杂匀的阳性信号主要分布于部分肾小管上皮细胞内。在肾小球系膜细胞也可检测到TIMP－1 mRNA阳性信号,但较肾小管弱,中度系膜增生型的TIMP－1 mRNA阳笥信号明显地较其他两型IgA肾病为强。以上结果表明：由肾小管上皮细胞及系膜细胞合成的TIMP－1通过抑制基质金属酶的活性,可导致细胞外基质（ECM）在肾小管间质及肾小球内过度沉积,从而对肾小球硬化有促进作用。     

转化生长因子-β蛋白及mRNA基因在人类系膜增生性肾小球肾炎中的表达

目的：探讨转化生长因子－β（TGF－β）蛋白及mRNA基因在系膜增生性肾小球肾炎中的表达及其在发病中的作用。方法：采用常规病理,免疫组织化学及原位杂交方法对人系膜增生性肾小球肾炎组织进行染色,并经医学图像分析系统进行分析,结果：在正常对照组,TGF－β蛋白及TGF－β1mRNA小肾小管上皮细胞呈极弱表达,肾小球内TGF－β蛋白及mRNA未见阳性表达,在系膜增生肾小球肾炎组织中,TGF－β蛋白在肾近曲小管上皮细胞胞浆内呈强阳性表达,肾小球球囊壁及系膜区呈阳性,肾小球与肾小管阳性表达与正常对照组相比均具有显性差异（P＜0．01）,TGF－β1mRNA阳性表达位于肾近曲小管上皮细胞胞浆内和肾小球系膜区,肾小球和肾小管上皮细胞TGF－β1mRNA阳性表达与正常对照组相比差异也有显性（P＜0．01）。结论：系膜增生性肾小球炎时TGF－β蛋白及TGF－β1mRNARNA阳性表达与正常对照组相比差异也有显性（P＜0．01）。结论：系膜增生性肾小球肾炎时TGF－β蛋白及TGF－β1mRNA在肾小球与肾小管表达均显增高,进一步显示TGF－β在肾小球系膜细胞增生及肾小管间质纤维化中所起的重要作用。     

紫癜性肾炎特异性结合肽的筛选与鉴定

目的:利用体内噬菌体展示技术筛选并鉴定紫癜性肾炎肾组织特异性结合肽。方法:构建大鼠紫癜性肾炎模型。尾静脉注射噬菌体展示环七肽库,筛选与紫癜性肾炎肾组织特异性结合的噬菌体,经过3轮体内筛选后,提取阳性单克隆噬菌体,并进行DNA测序。利用ELISA方法鉴定单克隆噬菌体对紫癜性肾炎的结合。通过化学合成的方法合成筛选获得的多肽,以流式细胞检测其与肾细胞的结合能力。同时,以合成的多肽体内封闭,检测噬菌体与合成多肽竞争结合紫癜性肾炎肾组织的能力。结果:成功筛选出于大鼠紫癜性肾炎肾组织结合的阳性噬菌体。在随机挑选的43个单克隆噬菌斑中,挑选了其中16个亲和力高的噬菌体,测序后获得了紫癜性肾炎的结合肽CQGPWKLTC。流式结果表明筛选的多肽能够与肾细胞特异性结合。获得的阳性噬菌体能够与紫癜性肾炎肾组织特异性结合,并且与体外合成的多肽具有竞争结合能力。结论:利用体内噬菌体展示技术筛选了与紫癜性肾炎肾组织特异性结合的肽CQGPWKLTC。     

逆转录PCR及原位杂交检测人IgA肾病肾脏中TGF-β mRNA

为研究转化生长因子－β（ＴＧＦ－β）在ＩｇＡ肾病病理机制中的作用,本文用逆转录ＰＣＲ（ＲＴ－ＰＣＲ）法及原位杂交法检测ＩｇＡ肾病患者肾活检组织中的ＴＧＦ－βｍＲＮＡ。结果证实：在人正常肾和ＩｇＡ肾病肾组织中均可检测到ＴＧＦ－βｍＲＮＡ的ＲＴ－ＰＣＲ扩增产物;ＴＧＦ－βｍＲＮＡ原位杂交的阳性信号主要分布于肾小管和集合管上皮细胞内,肾小球内的阳性信号较弱,且强度与系膜的增生程度有关。     

过敏性紫癜性肾炎肾组织中KIM-1的表达与临床意义

目的:探讨过敏性紫癜性肾炎肾组织中肾损伤分子1(kidney injury molecule 1,KIM-1)的表达与临床意义。方法:选择2015年4月到2018年1月在我院诊治的过敏性紫癜性肾炎患者150例作为研究对象,采用免疫组化法检测患者肾组织中KIM-1表达,采用半定量评分系统进行肾脏病理损害评分,并对二者进行相关性分析。结果:肾炎组织与肾旁组织的KIM-1相对表达量分别为(9.28±1.38)和(2.74±1.30),肾炎组织中KIM-1的表达显著高于肾旁组织(P=0.000);肾炎组织的毛细血管外肾小球活动、系膜增殖、内皮增殖、肾间质炎症、肾小球慢性化、肾小管间质慢性化指数评分均显著高于肾旁组织(P0.05);肾组织KIM-1表达量与肾小球慢性化指数、肾间质炎症指数、肾小管间质慢性化指数均呈显著正相关性(P0.05)。结论:过敏性紫癜性肾炎组织中KIM-1呈高表达,可能作为评估肾脏病理病变程度的参考指标。     

纤溶系统对膜性肾病大鼠足细胞损伤的影响

目的探讨早期预防纤溶紊乱对防止MN进展有重要意义。方法按改良Border法制作MN大鼠模型,正式免疫第1、2、3、4周末检测全血uPA、tPA及PAI-1的表达水平;取大鼠肾组织进行光镜、电镜观察肾组织病理学改变;采用免疫组化方法检测肾足细胞nephrin、WTl蛋白表达含量,并进行相关性分析。结果与正常组及干预组大鼠相比,模型组大鼠的全血uPA、tPA水平明显减少,而PAI-1水平明显增加,差异具有统计学意义(P0.05);电镜显示肾小球足细胞广泛足突融合至消失;GBM基质出现"钉样突起",肾间质纤维化程度较重。肾小球足细胞分布区WT-1和nephrin蛋白表达下调,其中nephrin蛋白表达量变化有统计学意义(P0.01)。相关性分析显示,大鼠全血tPA和uPA水平与肾组织nephrin蛋白的表达变化呈正相关,全血PAI-1水平与肾组织nephrin蛋白的表达变化呈现负相关。结论在MN发展中,纤溶系统对足细胞损伤凋亡具有重要意义,早期评估预测MN足细胞损伤情况或可为防治早期MN步入终末期肾脏病找到又一治疗靶点,亦可为临床研究治疗MN的药物提供新的思路。     

狼疮性肾炎患者肾组织中胎源性微嵌合体的表达及其临床意义

目的：探讨胎源性微嵌合体（FMc）与狼疮性肾炎（LN）的相关性。方法：收集生育过男胎的24例LN和24例肾小球轻微病变（GML）的女性患者肾活检组织,采用荧光原位杂交技术（FISH）检测细胞中的Y染色体,并收集患者孕育史、临床和实验室资料进行分析。结果：在9例LN和3例GML的肾组织中发现Y染色体阳性嵌合细胞,两组发生率的差异有统计学意义（P<0.05）,但在LN组,嵌合细胞的出现与蛋白尿、血清肌酐、抗双链DNA抗体、抗核抗体、补体C3、C4水平及SLEDAI评分等之间均无相关（P>0.05）。结论：FMc在女性LN患者肾组织中的发生频率高于对照组GML患者,但FMc的存在很可能与LN的发病、疾病活动性和进展性无关。     

M2型巨噬细胞在新月体性肾小球肾炎患者中的临床意义

本研究旨在探讨新月体性肾小球肾炎患者M2型巨噬细胞的临床病理意义,以及M2巨噬细胞标志物CD163和CD206的阳性表达情况。选择不同病因的超过30%以上新月体形成的肾小球性肾炎患者肾组织切片作为研究材料,其中,抗中性粒细胞胞浆抗体相关性血管炎(anti-neutrophil cytoplasmic antibody-associated vasculitis, AAV, n=16)、狼疮性肾炎(lupus nephritis, LN, n=13)、Ig A肾病(Ig A nephropathy, Ig AN, n=10)、紫癜性肾炎(Henoch-Schonlein purpura nephritis, HSPGN, n=10)被纳入本研究。另外,选择微小病变性肾病(minimal change disease, n=6)和正常对照肾脏(n=3)作为阴性对照。免疫组织化学和免疫荧光检测肾组织中CD163和CD206的表达。结果显示,LN和AAV中CD163阳性细胞数量显著高于Ig AN和HSPGN。与Ig AN和HSPGN相比,LN和AAV患者的肾小球病变中存在更多的CD206阳性细胞。CD163和CD206阳性细胞与新月体百分比、肾小球滤过率、血清白蛋白和尿蛋白之间存在显著相关性。总之,M2巨噬细胞参与了新月体性肾小球肾炎的发病机制和疾病进展,特别是在狼疮性肾炎和抗中性粒细胞胞浆抗体相关性血管炎中。     

单核细胞趋化蛋白-1、可溶性血管细胞黏附分子-1与小儿紫癜性肾炎及其并发肾损伤的关系研究

摘要 目的：分析单核细胞趋化蛋白-1（MCP-1）、可溶性血管细胞黏附分子-1（sVCAM-1）与小儿紫癜性肾炎及其并发肾损伤的关系。方法：选择我院在2018年1月至2020年12月期间收治的108例紫癜性肾炎患儿作为观察组,另选108例健康体检儿童作为对照组。检测两组血清MCP-1、sVCAM-1表达水平,分析紫癜性肾炎患儿血清MCP-1、sVCAM-1表达水平与肾功能指标的关系,通过受试者工作特征曲线（ROC）下面积（AUC）评价血清MCP-1联合sVCAM-1判断肾损伤的效能。结果：观察组血清MCP-1、sVCAM-1表达水平均高于对照组（P＜0.05）;观察组24 h尿蛋白定量（24 h Upro）、胱抑素C（Cys-C）、血肌酐（SCr）表达水平均高于对照组（P＜0.05）;经Pearson相关性分析,紫癜性肾炎患儿血清MCP-1、sVCAM-1表达水平均与24 h Upro、Cys-C、SCr表达水平呈正相关（P＜0.05）;在108例紫癜性肾炎患儿中,发生肾损伤34例;肾损伤组血清MCP-1、sVCAM-1表达水平均高于非肾损伤组（P＜0.05）;经ROC曲线分析,血清MCP-1联合sVCAM-1判断紫癜性肾炎患儿发生肾损伤的AUC为0.862,明显大于单一指标MCP-1的0.660和sVCAM-1的0.663（P＜0.05）。结论：紫癜性肾炎患儿血清MCP-1、sVCAM-1表达水平升高,与肾脏受累程度有关,联合判断肾损伤的效能较好,为监测病情演变提供了新的参考依据,值得临床予以重视。     

Chemokine amplification in mesangial cells.

Mesangial cells are specialized cells of the renal glomerulus that share some properties of vascular smooth muscle cells and macrophages. They are implicated in the pathogenesis of many forms of nephritis. The murine CXC-chemokines macrophage inflammatory protein-2 (MIP-2) and KC induce migration of mouse mesangial cells. Mesangial cells also exhibit a unique chemokine feedback mechanism. Treatment with nanomolar concentrations of MIP-2 or KC markedly up-regulates monocyte chemoattractant protein-1 and RANTES expression in mesangial cells. Autoinduction of MIP-2 and KC mRNA was also noted. Low levels of MIP-1alpha, MIP-1beta, and IFN-gamma-inducible protein-10 were induced following treatment with higher doses of MIP-2 or KC. These effects are specific to mesangial cells, as MIP-2 or KC treatment of renal cortical epithelial cells or peritoneal macrophages failed to induce chemokine production. This cascade of chemokine interactions may contribute to renal infiltration and leukocyte activation. The abilities of MIP-2 or KC to stimulate their own synthesis may also contribute to the maintenance and chronic course of glomerular inflammation. The mesangial cell receptor for MIP-2 and/or KC is unknown but is not CXC-chemokine receptor-2.     

Endotoxin induction of plasminogen activator and plasminogen activator inhibitor type 1 mRNA in rat tissues in vivo

The tissue-specific distribution of tissue-type and urokinase-type plasminogen activator (t-PA and u-PA) and their inhibitor type 1 (PAI-1) was analyzed at mRNA level in five major rat organ tissues. t-PA mRNA was detected in lung, kidney, heart, and liver. u-PA mRNA was detected in kidney and lung. Presence of PA mRNA correlated with the detection of PA activity in extracts of these tissues. PAI-1 mRNA was detected predominantly in heart and lung. Although PAI activity could not be measured directly in tissue extracts, the presence of PAI-1 mRNA correlated with the occurrence of PA.PAI complex in fibrin autography of tissue extracts. Endotoxin injection caused a very large increase in plasma PAI activity. This increase correlated with a marked increase in PAI-1 mRNA in nearly all tissues studied. The increase in PAI-1 mRNA is most pronounced in lung and liver. Endotoxin injection also caused an increased level of t-PA mRNA in heart and kidney, and an increased u-PA mRNA level in kidney. mRNA analysis of freshly isolated and separated subfractionated liver cells showed that the marked increase in PAI-1 mRNA in the liver after endotoxin injection may be due mainly to a strong increase of PAI-1 mRNA in the liver endothelial cells.     

紫癜性肾炎临床表现与肾脏损伤相关性分析

目的：分析紫癜性肾炎患者的,临床及病理资料,探讨两者之间相关性,并利用临床指标评估肾脏损伤的程度。方法：收集哈尔滨医科大学附属第一医院肾内科’肾活检及临床确诊为紫癜性肾炎的101例住院病人。分别比较年龄、病程、紫癜出现的次数、血压、蛋白尿、尿红细胞数、血肌酐、血浆白蛋白及纤维蛋白原与肾脏损伤程度之间的关系。结果：紫癜性肾炎肾脏损伤程度与病程（P〈0．0001）、血压（P〈0．0001）、蛋白尿（P〈0．0001）、血肌酐（P〈0．0001）、纤维蛋白原（P=0．0189）呈正相关;与血浆白蛋白（P〈0．0001）呈负相关;与年龄（P=0．6515）、紫癜出现的次数（P=0．912）、血尿（P：0．0781）没有统计学差异。结论：紫癜性肾炎的I陆床表现及化验指标,如紫癜的病程、紫癜出现的次数、血压、蛋白尿、血肌酐、血浆白蛋白及纤维蛋白原等与肾脏损伤的严重程度密切相关,通过对临床表现及化验指标的评价分析可以对肾脏损伤程度作出初步评估,对肾活检患者的选择、治疗方案的确定及判断预后均有一定的指导意义。     

阿托伐他汀治疗对肾脏衰老的影响

目的：观察长期应用不同剂量的阿托伐他汀对老年大鼠肾脏的影响。方法：正常20月龄Wistar雌性大鼠分为3组（n=9）：①给予大剂量阿托伐他汀10 mg/（kg.d）灌胃;②给予小剂量阿托伐他汀1 mg/（kg.d）灌胃;③给予等剂量生理盐水灌胃,三组均连续灌胃4个月后处死大鼠,以3月龄大鼠（n=9）为对照。测定肾重指数,血清肌酐及血清脂蛋白,行PAS染色、天狼猩红染色观察肾脏病理,计算肾小球硬化指数。结果：三组老年大鼠的肾脏重量均显著减轻。老年大鼠小剂量阿托伐他汀组显著降低老年大鼠的血清肌酐（P〈0.01）。老年大鼠血脂水平显著高于青年大鼠,大剂量阿托伐他汀组显著降低老年大鼠的总胆固醇（CH）和低密度脂蛋白胆固醇（LDL-C,P均〈0.05）,小剂量阿托伐他汀组显著降低老年大鼠的LDL-C（P〈0.05）。大剂量阿托伐他汀组降低血脂的作用强于小剂量阿托伐他汀组。老年大鼠肾脏病理改变为显著的肾小球局灶节段性硬化,肾小球硬化指数显著增高（P〈0.05）,肾间质内大量炎性细胞浸润,肾内小动脉明显硬化。阿托伐他汀组显著减轻肾小球的局灶节段性硬化的程度,减少肾间质内炎性细胞浸润,显著改善肾内小动脉粥样硬化的病变程度。大剂量阿托伐他汀改善肾组织异常病理表现的作用更为明显。结论：长期应用阿托伐他汀可以显著改善老年大鼠肾脏衰老的异常病理改变,这些作用可能是通过阿托伐他汀的降脂作用、显著减轻肾内小动脉硬化及显著减少肾间质内炎性细胞浸润而综合起效的。     

cDNA cloning and expression in Escherichia coli of a plasminogen activator inhibitor from human placenta

Two nearly full-length cDNAs for placental plasminogen activator inhibitor (PAI) have been isolated from a human placenta lambda gt11 cDNA library. One positive (lambda PAI-75.1) expressed a protein that could adsorb and purify anti-PAI antibodies. The expressed protein inhibited the activity of human urokinase in a fibrin autography assay, and formed a 79-kDa (reduced) covalent complex with 125I-urokinase that could be immunoprecipitated with anti-PAI. The cDNA insert of the longer isolate (lambda PAI-75.15) consisted of 1909 base pairs, including a 5'-noncoding region of 55 base pairs, an open reading frame of 1245 base pairs, a stop codon, a 3'-noncoding region of 581 base pairs, and a poly(A) tail. The size of the mRNA was estimated to be 2.0 kilobases by Northern blot analysis. The translated amino acid sequence consisted of 415 amino acids, corresponding to a 46.6-kDa protein. The sequence was related to members of the serpin gene family, particularly ovalbumin and the chicken gene Y protein. Like these avian proteins, placental PAI appears to lack a cleavable NH2-terminal signal peptide. Residues 347-376 were identical to the partial sequence reported recently for a PAI isolated from the human monocytic U-937 cell line. Placental PAI mRNA was apparently expressed at low levels in human umbilical vein endothelial cells, but was not detectable in HepG2 hepatoma cells. It was present in U-937 cells and was inducible at least 10-fold by phorbol 12-myristate 13-acetate. Thus placental PAI is a unique member of the serpin gene family, distinct from endothelial-type PAI. It is probably identical to monocyte-macrophage PAI.     

Anti-dsDNA Antibodies Promote Initiation,and Acquired Loss of Renal Dnase1 Promotes Progression of Lupus Nephritis in Autoimmune (NZBxNZW)F1 Mice

Background

Lupus nephritis is characterized by deposition of chromatin fragment-IgG complexes in the mesangial matrix and glomerular basement membranes (GBM). The latter defines end-stage disease.

Methodology/Principals

In the present study we determined the impact of antibodies to dsDNA, renal Dnase1 and matrix metalloprotease (MMP) mRNA levels and enzyme activities on early and late events in murine lupus nephritis. The major focus was to analyse if these factors were interrelated, and if changes in their expression explain basic processes accounting for lupus nephritis.

Findings

Early phases of nephritis were associated with chromatin-IgG complex deposition in the mesangial matrix. A striking observation was that this event correlated with appearance of anti-dsDNA antibodies and mild or clinically silent nephritis. These events preceded down-regulation of renal Dnase1. Later, renal Dnase1 mRNA level and enzyme activity were reduced, while MMP2 mRNA level and enzyme activity increased. Reduced levels of renal Dnase1 were associated in time with deficient fragmentation of chromatin from dead cells. Large fragments were retained and accumulated in GBM. Also, since chromatin fragments are prone to stimulate Toll-like receptors in e.g. dendritic cells, this may in fact explain increased expression of MMPs.

Significance

These scenarios may explain the basis for deposition of chromatin-IgG complexes in glomeruli in early and late stages of nephritis, loss of glomerular integrity and finally renal failure.     

Evaluation of sequential glomerular eluates from rats with Heymann nephritis

This study was undertaken to characterize the antigen-antibody content of sequential glomerular eluates from rats with Heymann nephritis. Serum and renal tissue were harvested every 2 wk after immunization with renal tubular antigen (Fx1A). Circulating antibody to the tubular antigen was detectable in the circulation from days 7 to 98. Direct immunofluorescence of renal tissue demonstrated an increase in IgG deposits through day 49 with stabilization thereafter. Tubular antigen deposits peaked at day 49 and then declined. One-hour and 3-hr acid eluates of isolated glomeruli were analyzed for IgG content, antibody specificity, and antigen content. Antibody from the 1-hr eluate bound to the tubular brush border but not the glomerulus, whereas the 3-hr eluate demonstrated binding to the glomerulus and not to the tubular brush border. In addition to rat IgG, the 1-hr eluate demonstrated a 70 kD band and the 3-hr eluate demonstrated a 45 kD band by polyacrylamide gel electrophoresis. By Western blot, antibody to the brush border bound to the 70 kD band. Anti-idiotypic antibody to anti-Fx1A, which binds to the glomerulus by indirect immunofluorescence, bound to the 45 kD band. The 3-hr eluate, but not the 1-hr eluate, precipitates radiolabeled F(ab')2 fragments from anti-Fx1A antibody but not from normal rat IgG. Quantitative analysis of the sequential eluates demonstrated that the 70 kD-anti-Fx1A system predominated early in the course of disease, whereas the 45 kD-anti-idiotype antigen-antibody system predominated late in the course of the disease. These observations confirm that two antigen-antibody systems contribute to the immune deposits in Heymann nephritis.     

Therapeutic effect of artemisinin on lupus nephritis mice and its mechanisms

In this study, we investigated the therapeutic effect of artemisinin (Art) on lupus nephritis mice and its mechanisms by comparing the differences between lupus nephritis (LN) mice given Art and control mice in molecular biology, immunohistochemistry, and histopathology. The results showed that Art could remarkably relieve the symptoms, decrease the level of urine protein/24 h, and alleviate pathological renal lesions. The differences among the four groups in the expression of the NF-κBp65 protein, nuclear factor-κB (NF-κB) activity, and the expression of transforming growth factor-β1 (TGF-β1) mRNA in renal tissue suggested that Art can lower the serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and inhibit the expression of the NF-κBp65 protein and NF-κB and TGF-β1 mRNA in the renal tissues of LN mice. These results proved that it is reliable and effective to use Art to treat LN mice, and its therapeutic mechanisms should closely be related to the fact that Art can obviously decrease the serum levels of TNF-α and IL-6 and down-regulate the expression of the NF-κBp65 protein and NF-κB and TGF-β1 mRNA in renal tissues.