摘要
目的探讨血、尿和系膜区TNF-α,血IL-12、IL-15及肾组织低糖基化IgA1(UG IgA1)对IgAN病情的影响。方法IgAN 74例,随机选择IgAN缓解后、MCD及健康人各10例作对照组。检测血、尿TNF-α(放免法)、血IL-12及IL-15(ELISA法)浓度,TNF-α(组化法)、肾组织UG IgA1(直接荧光法)表达。结果IgAN血清TNF-α、IL-12和IL-15含量高于MCD、健康对照和IgAN缓解后组;33例肾组织UG IgA1阳性,其血TNF-α低于、病程长于阴性组,肾组织病变程度轻于阴性组;肾组织TNF-α阳性面积、血TNF-α浓度与尿蛋白排泄量正相关(r=0.249,0.702,P=0.000),随肾组织病变加重而升高。血TNF-α浓度与Ccr负相关(r=-0.231,P=0.048);IL-15浓度与病程正相关(r=0.266,P=0.022)、与Scr负相关(r=-0.320,P=0.005)。结论血TNF-α、IL-12和IL-15与IgAN蛋白尿形成有关;系膜区UG IgA1阳性者病程较长、肾组织病变较轻;IL-15是抗肾损伤因子;TNF-α是IgAN病情加重一个重要因素。
Objective To investigate the effects of TNF-α, IL-12, IL-15 and underglycosylation IgA1 in mesangial deposition in the clinicopathological study of IgA nephropathy （IgAN）. Methods Seventy-four patients with IgAN were enrolled in the study, with 10 patients randomly selected after remissinn, 10 MCD and IO healthy volunteers as control groups. The levels of TNF-α in serum and urine were examined by radioimmunoassay, and the levels of IL-12 and IL-15 were examined by ELISA. Immunohistoehemistry was used to detect the expression of TNF-α in renal tissue, and the directed immunofluorescence was used to detect the underglycosylation of IgA1 （ UGIgA1 ）in mesangial deposition. Results The levels of TNF-α, IL-12 and IL-15 in serum of patients with IgAN were higher than those of MCD group, healthy control group and remission group. Compared with the negative group, 33 patients with UGIgA1 positive in renal tissues had lower levels of TNF-α in serum, longer course and less less of renal tissue injury. The positive areas of TNF-α in renal tissue and levels of TNF- α in serum were positively correlated with urinary protein（ r =0. 249 ,0. 702, P =0. 000）. There was negative correlation between the levels of TNF-α in serum and Ccr（ r = -0. 231, P =0. 048）. The levels of IL-15 was positively correlated with the course of disease（ r = 0. 266, P =0. 022） and negatively with Scr（ r = -0. 320, P =0. 005）. Conclusions The TNF-α, IL-12 and IL-15 are all involved in the onset of proteinuria in IgAN patients, and IL-15 acts as a factor against renal injury. The patients with UGIgA1 positive in mesangial have longer course and less pathological changes damaged than those of the UGIgA1 negative patients. The TNF-α may serve as an important factor in the aggravation of IgAN.
出处
《中国医师杂志》
CAS
2006年第1期23-26,共4页
Journal of Chinese Physician
基金
河北省卫生厅资助课题(2003058)
