黏附分子P-选择素与树突状细胞在人肾小管间质病变中的作用

目的 观察黏附分子P-选择素与树突状细胞(DC)在人肾炎。肾组织中的表达与分布，探讨P-选择素和DC与肾小管间质病变以及。肾功能损害的关系。方法 选择经肾活检和临床资料确诊的不同类型肾炎患者133例，根据小管间质病变分为三组：轻度组63例，中度组44例，重度组26例；10例正常人肾组织作为对照。采用免疫组化法观察肾炎患者肾组织中P-选择素的表达；利用免疫双染与荧光图像分析法，观察CDla^ CD80^ DC在肾组织中的分布和改变，并探讨与肾小管间质病变和肾功能损害的关系。结果 肾炎患者肾组织中P-选择素表达增强，在肾小管上皮细胞表达显著高于。肾小球、。肾间质和。肾血管；而在。肾小管间质表达于重度组又明显高于轻、中度组，并与。肾小管间质病变程度显著相关。CDla^ CD80^ DC在肾组织中分布面积、数量和密度均显著增多，且以。肾小管间质为主，分布于肾小管、。肾间质和肾血管；其在。肾小管间质分布于重度组也明显高于轻、中度组，并与。肾小管间质病变程度以及。肾功能明显相关。此外，CD1a^ CDSO^ DC肾小管间质分布状况亦与P一选择素表达显著相关。结论 黏附分子；P-选择素可能介导DC肾炎。肾组织中迁移聚集，参与了肾脏免疫病理机制，并与。肾小管间质病变密切相关。

Role of P-selectin and dendritic cells in human renal tubulointerstitial lesions

Objective To observe the expression of P-selectin and the localization of dendritic cells (DCs) in the human kidney with nephritis, and to evaluate their functions in human renal tubulointerstitial lesions and renal dysfunction. Methods We choosed biopsy specimen of 133 patients with nephritis, and divided them into three groups according to the degree of renal tubulointerstitial lesions, and 10 normal individuals were observed in the same time. The expression of P-selectin was analyzed by immunohistochemistry. CDla+CD80+DC was investigated by the double immunostaining method and the images were analyzed with Axioplan 2 microscopy. Results P-selectin was much more in the renal tubular epithelial cells than in the glomeruli and interstitium, and was also greater in the severe group than the mild and moderate group. The expression of P-selectin was associated with the degree of renal tubulointerstitial lesions. In the renal tissues of patients with nephritis, CDla+ CD80+ DC was found in the renal tubules, interstitium and vessels, especially tubulointerstitium. The distribution area, number and density of CDla+ CD80+ DC in the severe group were much more than other groups, and were associated with the degree of renal tubulointerstitial lesions and the levels of serum creatine and clearance of creatine. The distribution of CDla+ CD80+ DC was associated with the expression of P-selectin in the renal tubulointerstitium. Conclusion The study demonstrated that DCs recruited into the kidney with nephritis were mediated by P-selectin, which played an important role in the immune pathogenesis of nephritis and were associated with renal tubulointerstitial lesions.