摘要
目的：观察血管细胞粘附分子－１（ＶＣＡＭ－１）在不同类型新月体肾炎患者肾组织中的分布，分析ＶＣＡＭ－１在新月体肾炎发病机制中的作用及其在诊断与治疗中的应用价值。方法：利用肾活检组织，采用免疫组化方法，观察ＶＣＡＭ－１、ＣＤ４＋、ＣＤ８＋和ＣＤ６８＋细胞在不同患者中的分布及甲基强的松龙（ＭＰ）冲击治疗后的变化。结果：不同类型新月体肾炎肾小球新月体处ＶＣＡＭ－１均呈强阳性表达。ＶＣＡＭ－１表达增加与肾小球毛细血管袢坏死的发生无明显相关性。新月体肾炎患者肾小管及间质细胞ＶＣＡＭ－１的表达明显高于正常人，其表达程度与间质炎性细胞浸润间无明显相关性，而且不同类型患者间差异不明显。ＭＰ冲击治疗能明显减少肾组织炎性细胞浸润程度，但对ＶＣＡＭ－１的表达无明显影响。结论：ＶＣＡＭ－１是介导新月体肾炎新月体形成的一个重要因素。新月体肾炎存在肾小管上皮及间质细胞ＶＣＡＭ－１的异常表达，ＭＰ冲击治疗对其无明显影响。
OBJECTIVE To investigate the distribution of vascular cell adhesion molecule 1(VCAM 1)in the renal tissue from the patients with different type of crescentic glomerulonephritis and to evaluate its pathogenic role and clinical implications. METHODOLOGY Renal biopsy tissues obtained from 23 patients with crescentic glomerulonephritis(Type Ⅰ, n =7;Type Ⅱ, n =7;Type Ⅲ, n =9)were used in this study.The distribution of VCAM 1,CD4 +,CD8 +and CD68 + cells were detected by immunofluorescence staining with specific antibodies and were analyzed semiquantitatively.The normal control renal specimens obtained from the donor of renal transplantation.The effect of methylprednisolone(MP)therapy on the expression of VCAM 1 in the renal tissue was evaluated by repeating renal biopsy in these patients. RESULTS It was found that VCAM 1 strongly distributed in the areas of crescents in all glomeruli with crescentic formation among three types of crescentic glomerulonephritis.There was no association between the glomerular capillary segmental necrosis and the presence of VCAM 1 deposition in these patients.The expression of VCAM 1 on the renal tubules and interstitium were markedly increased in all of these patients as compared to the normal controls.Repeat renal biopsies showed that the expression of VCAM 1 had no changes in both of the glomeruli and interstitium after MP pulse therapy,although the cellular infiltration in renal tissue was diminished markedly by MP treatment. CONCLUSION VCAM 1 plays an important role in the pathogenesis of glomerular crescentic formation in the crescentic glomerulonephritis and the upregulation of VCAM 1 expression on renal tubules and interstium may participate in the mediation of tubulointerstitial lesions in this disease. MP pulse therap
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1998年第5期429-432,共4页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
新月体肾炎
炎症因子
VCAM-1
crescentic glomerulonephritis vascular cell adhesion molecule 1 cytokine
