IgA肾病肾小管间质中淋巴细胞亚群分布及其临床意义探讨-东南大学学报医学版

IgA肾病肾小管间质中淋巴细胞亚群分布及其临床意义探讨

单位：东南大学附属中大医院肾脏病研究所, 江苏南京 210009

分类号：R692.6

出版年·卷·期（页码）：2015·34·第六期（876-880）

摘要：

目的:探讨IgA肾病(IgA nephropathy,IgAN)肾小管间质中淋巴细胞亚群分布与临床肾功能的关系及其意义.方法:对48例IgAN患者穿刺肾组织石蜡切片行Masson三色染色,按牛津分类将48例IgAN患者分为T0、T1和T2组,用CD4、CD8和CD20一抗行免疫组化染色,分别标记T淋巴细胞亚型(CD4、CD8)和B淋巴细胞(CD20).采用Image-Pro Plus图像分析系统分析免疫组化结果,结合相关病理参数(肾小球硬化、肾小管萎缩、间质纤维化程度)及临床指标,应用SPSS 13.0统计软件进行统计学分析.结果:CD4⁺、CD8⁺、CD20⁺的细胞数量在不同纤维化组别间差异有统计学意义(P<0.05).CD4⁺、CD8⁺、CD20⁺的细胞数量与不同临床、病理指标呈正相关.结论:间质中浸润淋巴细胞的不同数量和类型影响IgAN临床特征及肾脏纤维化的进展.

Objective:To investigate the distribution and clinical significance of lymphocytes and their subsets in renal tubulointerstitium of IgA nephropathy (IgA nephropathy, IgAN). Methods:We stained paraffin sections of 48 cases of IgAN patients for Masson. According to Oxford classification, 48 cases of IgAN patients were divided into 3 groups: T0,T1 and T2. CD4, CD8 and CD20 primary antibodies were immunohistochemically stained, and marked as T lymphocyte subsets(CD4⁺, CD8⁺), B lymphocytes(CD20⁺), respectively. Immunohistochemistry results were analyzed by Image-Pro Plus image system, combined with the related pathological parameters(glomerulosclerosis, tubular atrophy, interstitial fibrosis) and clinical index. We also used SPSS 13 statistical software for statistical analysis. Results: There was a significant difference between the quantity of CD4⁺, CD8⁺, CD20⁺cells between different fibrosis groups, P<0.05. The number of cells of CD4⁺, CD8⁺and CD20⁺was positively correlated with different clinical and pathological indexes. Conclusion:The number and type of infiltrating lymphocytes in renal tubular interstitium influence IgAN clinical features and the progress of renal fibrosis.

参考文献：

[1] CATTRAN D C,COPPO R,COOK H T,et al.The Oxford classification of IgA nephropathy:rationale,clinicopathological correlations,and classification[J].Kidney Int,2009,76:534-545.
[2] SMITH S W,SCHRIMPF C,PAREKH D J,et al.Kidney pericytes:a novel therapeutic target in interstitial fibrosis[J].Histol Histopathol,2012,27(12):1503-1514.
[3] FARRIS A B,COLVIN R B.Renal interstitial fibrosis:mechanisms and evaluation[J].Curr Opin Nephrol Hypertens,2012,21(3):289-300.
[4] MYLLYMAKI J M,HONKANEN T T,SYRJANEN J T,et al.Severity of tubulointerstitial inflammation and prognosis in immunoglobulin A nephropathy-348.
[5] ALEXOPOULOS E,SERON D,HARTLEY R B,et a1.The role of interstitial infiltrates in IgA nephropathy:a study with monoclonal antibodies-195.
[6] HAMEL K,DOODES P,CAO Y,et al.Suppression of proteoglycan-induced arthritis by anti-CD20 B cell depletion therapy is mediated by reduction in autoantibodies and CD4⁺T cell reactivity-5003.
[7] KURTULUS S,HILDEMAN D.Assessment of CD4(+) and CD8 (+) T cell responses using MHC class I and II tetramers-79.
[8] STEPHEN R H,KITCHING A,PETER G T.Thl and Th2 T helper cell subsets affect patterns of injury and outcomes in glomerulonephritis[J].Kidney Int,1999,55:1198-1216.
[9] STEINMETZ O M,VELDEN J,KNEISSLER U,et al.Analysis and classification of B-cell infiltrates in lupus and ANCA-associated nephritis-457.
[10] COHEN C D,CALVARESI N,ARMELLONI S,et al.CD20-positive infiltrates in human membranous glomerulonephritis-333.
[11] MENGEL M,GWINNER W,SCHWARZ A,et al.Infiltrates in protocol biopsies from renal allografts-365.
[12] HIPPEN B E,DeMATTOS A,COOK W J,et al.Association of CD20⁺infiltrates with poorer clinical outcomes in acute cellular rejection of renal allografts-2252.
[13] 王惠,许旌,张洪.2型糖尿病患者外周血T淋巴细胞亚群和NK细胞的变化及其临床意义[J].现代医学,2010,38(2):137-140.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录