骨碎补总黄酮对系膜增生性肾炎大鼠血清白细胞介素-6的影响

目的：观察骨碎补总黄酮对系膜增生性肾小球肾炎大鼠血IL-6及尿蛋白的影响。方法：利用免疫法制备大鼠系膜增生性肾小球肾炎模型,将大鼠分为骨碎补总黄酮组（治疗组）、病理对照组（模型组）、正常对照组,检测各组24h尿蛋白、血清IL-6,并观察肾脏病理改变。结果：模型组大鼠肾脏系膜细胞明显增生,与正常对照组比较24h尿蛋白定量及血清IL-6明显升高（P＜0．05）;治疗组大鼠肾脏系膜细胞增生减轻,24h尿蛋白、血IL-6均明显低于模型组（P＜0．05）。结论：骨碎补总黄酮能降低系膜增生性肾小球肾炎大鼠尿蛋白,降低血清IL-6水平,减轻系膜细胞增生和细胞外基质增加,延缓或减轻肾组织损伤,保护肾功能。     

益肾饮合雷公藤多苷对系膜增生性肾小球肾炎大鼠TNF-α和IL-6蛋白表达的影响

目的：探讨益肾饮合雷公藤多苷对大鼠系膜增生性肾小球肾炎中肿瘤坏死因子-α（TNF-α）和白细胞介素6（IL-6）蛋白表达的影响。方法：实验大鼠随机分为空白对照组、模型组、雷公藤多苷组、益肾饮组、雷公藤多苷加益肾饮组。制备大鼠系膜增生性肾小球肾炎模型;以雷公藤多苷和益肾饮灌胃;观察各组肾脏病理变化;免疫组织化学检测各组大鼠肾脏组织中TNF-α和IL-6蛋白表达。结果：模型组大鼠肾脏系膜细胞增生明显,系膜组织中TNF-α和IL-6蛋白表达明显升高。用益肾饮和雷公藤多苷各自治疗和合用治疗大鼠系膜增生性肾小球肾炎后肾脏系膜细胞增生均减轻,系膜组织中TNF-α和IL-6的蛋白表达均下降,合用后效果更为明显。结论：益肾饮联合雷公藤多苷能有效地降低系膜组织中TNF-α和IL-6的蛋白表达,减轻系膜细胞的增生。     

益肾饮合雷公藤多苷对系膜增生性肾小球肾炎大鼠TNF-α和IL-6蛋白表达的影响

目的：探讨益肾饮合雷公藤多苷对大鼠系膜增生性肾小球肾炎中肿瘤坏死因子-α（TNF-α）和白细胞介素6（IL-6）蛋白表达的影响。方法：实验大鼠随机分为空白对照组、模型组、雷公藤多苷组、益肾饮组、雷公藤多苷加益肾饮组。制备大鼠系膜增生性肾小球肾炎模型;以雷公藤多苷和益肾饮灌胃;观察各组肾脏病理变化;免疫组织化学检测各组大鼠肾脏组织中TNF-α和IL-6蛋白表达。结果：模型组大鼠肾脏系膜细胞增生明显,系膜组织中TNF-α和IL-6蛋白表达明显升高。用益肾饮和雷公藤多苷各自治疗和合用治疗大鼠系膜增生性肾小球肾炎后肾脏系膜细胞增生均减轻,系膜组织中TNF-α和IL-6的蛋白表达均下降,合用后效果更为明显。结论：益肾饮联合雷公藤多苷能有效地降低系膜组织中TNF-α和IL-6的蛋白表达,减轻系膜细胞的增生。     

商陆皂苷甲对大鼠抗Thy1系膜增生性肾炎的治疗作用

目的：探讨商陆皂苷甲（EsA）对大鼠抗Thy1系膜增生性肾炎的治疗作用。方法：制备大鼠抗Thy1系膜增生性肾炎模型,随机分为EsA治疗组、地塞米松治疗组、未治疗组（模型组）。另设正常对照组。隔日测定24h尿蛋白定量。所有大鼠第8天处死,取肾脏组织,显微镜观察肾组织系膜增生程度,利用图像分析系统对系膜区占据肾小球面积进行分析。结果：EsA治疗组及地塞米松治疗组3、5、7天24h尿蛋白与模型组相应时间点比较均明显下降（P〈0.01～0.001）;EsA治疗组及地塞米松治疗组肾小球系膜细胞及基质增生程度较模型组明显减轻（P〈0.05）。结论：EsA对大鼠抗Thy1系膜增生性肾炎具有降低尿蛋白、抑制肾小球系膜细胞及系膜基质的增生的作用。     

肾炎康对大鼠系膜增生性肾炎白介素-6的影响

目的：探讨中药肾炎康对大鼠系膜增生性肾炎（MsPGN）模型病理改变及尿和血中白介素6（IL-6）的影响。寻找肾炎康治疗MsPGN的机制。方法：采用大鼠慢性血清病性MsFGN模型，于造模第6周起，治疗组灌服肾炎康口服液3ml／d，模型组灌服等量自来水为对照，6周后观察MsPGN模型肾脏病理改变、24h尿蛋白定量（TP／24h），尿及血IL-6含量及肾功能。结果：病理组系膜细胞弥漫性增生、节段性加重，肾小管亦有明显病变，尿TP／24h、尿及血IL-6含量及BUN、Scr均显著高于正常大鼠（均P〈0．01）；治疗组系膜增生比病理组轻，多为节段性增生，肾小管病变轻微，尿蛋白、尿及血IL-6、BUN及Scr虽亦高于正常大鼠（P〈0．05或P〈0．01），但显著低于病理组（P〈0．05或P〈0．01）。结论：肾炎康能降低MsPGN大鼠尿蛋白，降低尿及血中IL-6含量，改善肾功能，抑制系膜细胞增生。肾炎康治疗MsPGN机制可能与其抑制IL-6分泌有关。     

通脉口服液对肾小球系膜细胞增殖及白细胞介素β1、白细胞介素10表达的影响

目的：探讨中药复方“通脉口服液”对大鼠肾小球系膜细胞（MsC）增殖及其产生白细胞介素融（IL-β1）和白细胞介素10（IL-10）的影响。方法：应用细胞培养技术进行肾小球系膜细胞的传代培养，采用血清药理学方法，制备通脉口服液含药血清，采用四甲基偶氮唑盐（MTT）法测定通脉口服液含药血清对过度增殖状态下肾小球系膜细胞增殖的影响，酶联免疫吸附法（ELISA）及逆转录聚合酶链反应（RT—PEn）法测定系膜细胞IL—β1 mRNA和IL-10mRNA表达及其蛋白水平。结果：通脉口服液含药血清在5％～20％浓度范围明显抑制脂多糖（LPS）刺激的系膜细胞增殖；在观察的2个时间点（6h、24h）上，LPS均可刺激系膜细胞IL-β1 mRNA的表达及提高IL-β1 分泌水平，在6h时间点上LPS可刺激系膜细胞IL-10mRNA的表达及提高IL-10分泌水平；而通脉口服液在10％浓度上能够明显抑制LPS诱导的系膜细胞IL-β1 分泌及其mRNA的表达，在6h时间点上促进LPS诱导的系膜细胞IL-10分泌及其mRNA的表达。结论：中药复方“通脉口服液”可抑制肾小球系膜细胞的增殖及LPS诱导的系膜细胞IL-β1 的产生，促进LPS诱导的系膜细胞IL-10的产生；肾小球系膜细胞是通脉口服液防治慢性肾炎，延缓肾小球硬化的重要靶细胞之-。     

肾病Ⅰ号方对大鼠系膜细胞增殖及IL-6和FN表达的影响

目的：观察肾病Ⅰ号方（SBYHF）对体外培养的大鼠肾小球系膜细胞（GMC）的增殖及表达纤维连接蛋白（FN）及白细胞介素-6（IL-6）的影响,探讨其抗肾纤维化的机制。方法：通过体外培养大鼠肾小球系膜细胞技术及体外药物血清实验方法,采用CCK-8法检测GMC的增殖,ELISA法检测FN的分泌水平,RT-PCR法检测IL-6 mRNA的表达。结果：肾病Ⅰ号方可显著抑制GMC和增殖（P〈0.01）,减少FN的分泌和IL-6 mRNA的表达（P〈0.01）。结论：肾病Ⅰ号方可能通过减少GMC和FN的分泌,下调IL-6 mRNA表达,而抑制大鼠肾小球系膜细胞增殖,从而发挥抗肾脏纤维化的作用。     

高糖对原代培养人系膜细胞表达FN与IL-6的影响

目的：了解高糖对原代培养的人肾小球系膜细胞表达FN、IL-6的影响,并进一步探讨糖尿病肾病的发病机制。方法：取自愿水囊引产的胎儿肾,解剖取肾皮质剪碎,应用肾皮质组织块法合优生选择法培养人肾小球系膜细胞。ELISA方法检测FN、IL-6的表达。结果：与正常组相比较,高糖组FN、IL-6在24 h、48 h、72 h均显著升高（P〈0.05或P〈0.01）。结论：高糖能够升高系膜细胞FN、IL-6分泌,这可能与肾小球系膜细胞细胞外基质积聚和糖尿病肾病发病密切相关。     

从白细胞介素-13和病理改变探讨丹芍丸对大鼠系膜增生性肾炎模型的作用

目的：探讨丹芍丸对大鼠系膜增生性肾炎（MsPGN）模型肾组织白细胞介素-13（IL-13）表达及肾脏病理改变的影响。方法：40只雄性SD大鼠随机分成4组,每组10只,设置正常对照组、模型对照组、激素对照组、丹芍丸治疗组;除正常组外,其余各组采用抗Thy-1大鼠肾炎模型。在实验的第28天处死各组大鼠取肾组织切片,通过原位杂交技术（ISH）检测肾组织IL-13mRNA的表达;通过光镜、电镜观察大鼠肾组织形态学的改变,进行肾组织学分级及肾小球损害、肾小管间质损害积分评定,并检测各组大鼠实验前后的血尿素氮（BUN）、血肌肝（Scr）、24h尿蛋白定量、尿红细胞计数等指标。结果：肾组织IL-13表达与大鼠MsPGN模型肾小球损害、肾小管间质损害程度呈正相关。正常对照组肾组织无明显IL-13表达,模型对照组肾组织IL-13表达较正常组明显上调（P〈0.01）;丹芍丸治疗组与激素对照组实验后肾组织IL-13表达较模型对照组均明显下调（P〈0.01）,组间比较有统计学差异（P〈0.05）;丹芍丸治疗组与激素对照组实验后肾组织病理半定量积分均减少明显（P〈0.01）,组间比较优势明显（P〈0.01）。丹芍丸治疗组实验后BUN、Scr、24h尿蛋白定量、尿红细胞计数等指标均明显改善,与激素对照组实验后比较优势明显（P〈0.05或P〈0.01）。结论：IL-13在MsPGN的发病过程起重要的调控作用,丹芍丸能改善肾小球损害、肾小管间质损害程度,经丹芍丸治疗后肾组织IL-13表达下调,肾脏炎症程度明显改善,丹芍丸可能是通过调控MsPGN肾组织IL-13的产生而起效。     

Intrarenal synthesis of IL-6 in IgA nephropathy

Summary: Recent in vitro studies have shown the synthesis of interleukin-6 (IL-6) in glomerular mesangial and epithelial cells, and suggested the involvement of IL-6 in mesangial proliferative glomerulonephritis. However, the expression site of IL-6 mRNA in renal tissue of IgA nephropathy (IgAN), the most common chronic mesangial proliferative glomerulonephritis, remains obscure. to localize IL-6 mRNA in renal biopsy specimens of IgAN, we used nonradioactive in situ hybridization (ISH) developed in our laboratory, sensitive in detecting individual cells positive for a specific mRNA. In some sections, periodic acid-Schiff staining was performed after ISH in order to identify the topographical relation between IL-6 mRNA positive cells and glomerular basement membrane and mesangial area. In situ hybridization for IL-6 mRNA and immunohistochemistry for CD3 and CD68, markers for lymphocytes and monocytes, respectively, were also performed on serial sections to examine the contribution of infiltrated mononuclear cells to cells positive for IL-6 mRNA in glomeruli. Glomerular resident cells, including glomerular mesangial and epithelial cells and cells of Bowman's capsule, as well as tubular epithelial cells and infiltrated mononuclear cells expressed IL-6 mRNA. We also compared the localization of IL-6 mRNA and protein and showed different distribution between the gene product and protein. the expression of IL-6 mRNA correlated with the degree of mesangial cell proliferation and tubulointerstitial changes. Our results indicate that IL-6 is synthesized in renal tissues of IgAN and suggest that the increased IL-6 expression may be important in the pathogenesis of IgAN.     

Induction of interleukin 6 synthesis in mouse glomeruli and cultured mesangial cells.

Interleukin 6 (IL-6) is an autocrine growth factor of cultured mesangial cells (MC) and intraglomerular IL-6 production is suggested to be closely associated with the pathogenesis of human mesangial proliferative glomerulonephritis (mesPGN). In this study, to elucidate the mechanisms regulating the intraglomerular production of IL-6, we examined what kinds of stimuli are significant in the induction of IL-6 synthesis in vitro and in vivo. Incubation of cultured mesangial cells with interleukin 1 (IL-1) or bacterial lipopolysaccharide (LPS) induced significant IL-6 production, and intravenous injection of IL-1 or LPS into normal BALB/c mice induced significant intraglomerular IL-6 mRNA expression. Furthermore, we indicated in this study that IL-6 mRNA expression was augmented in the glomeruli of mice with immune complex-mediated glomerulonephritis.     

IL-1 receptor antagonist inhibits monocyte chemotactic peptide 1 generation by human mesangial cells.

The elicitation of neutrophils and monocytes from the circulation into the inflamed glomerulus is a key process in the pathogenesis of proliferative glomerulonephritis. The aim of this study was to determine the factors which regulate the expression and synthesis of the monocyte specific chemotaxin, monocyte chemotactic peptide 1 (MCP-1). Mesangial cells in culture did not constitutively express MCP-1, but could be induced to express both MCP-1 mRNA and antigenic MCP-1 by either stimulation with IL-1 alpha or TNF alpha, which are also stimuli for interleukin 8 (IL-8/NAP-1) expression and release. Pre-treatment of mesangial cells with the IL-1 receptor antagonist (IL-1ra) induced dose-dependent inhibition of both the expression of MCP-1 and IL-8 mRNA as well as the release of both chemotactic peptides in response to IL-1 alpha, while the receptor antagonist had no significant effect on TNF alpha induced MCP-1 and IL-8 generation. This study demonstrates that the IL-1 receptor antagonist was four times more effective at inhibiting the IL-1 induced expression and release of IL-8 compared to that of MCP-1. These results suggest that mesangial cell-derived MCP-1 may play an important role in the recruitment of monocytes in glomerular inflammation and that an IL-1 receptor antagonist may have therapeutic potential for the treatment of glomerulonephritis.     

Increased IL-6 in supernatant of rat mesangial cell cultures treated with erythrogenic toxin type B and its precursor isolated from nephritogenic streptococci

BACKGROUND/AIMS: Previous reports have shown the presence of streptococcal erythrogenic toxin type B (ETB), IL-8, transforming growth factor-beta (TGF-beta) and glomerular proliferation in renal biopsies from patients with acute poststreptococcal glomerulonephritis (APSGN). In addition, increased levels of plasma IL-6 and tumor necrosis factor-alpha (TNFalpha) and urinary IL-6 have also been reported in this disease. To determine the effect of ETB in mesangial cell cytokine production and proliferation, the concentration of several cytokines (IL-6, IL-1beta, TNFalpha, IL-10, IL-4, RANTES), soluble TNF receptor I (STNFR-I), soluble TNF receptor II (STNFR-II) and proliferation were measured in rat mesangial cells cultures after treatment with ETB or its precursor (ETBP). METHODS: To analyze the levels of cytokines and production of soluble receptors as well as proliferation, rat mesangial cells were cultured with ETB or ETBP (50 microg/ml). After 24, 48 and 96 h of incubation, culture supernatants were assessed for cytokines and receptors by ELISA and for proliferation by incorporation of radioactive thymidine. RESULTS: A significant increase in IL-6 levels was found in mesangial cell cultures treated with either ETBP or ETB when compared with controls. Streptococcal proteins treated mesangial cells also showed elevated levels of proliferation at 96 h. Increased production of IL-6 was not correlated with proliferation. A polyclonal anti-ETB antibody abolished the IL-6 stimulatory effect of ETB on mesangial cells. ETB/ETBP failed to increase the levels of other cytokines and cytokine soluble receptors. CONCLUSION: Streptococcal ETB/ETBP is capable of inducing increased production of IL-6 and proliferation on mesangial cells. These findings could be relevant in a possible early interaction of streptococcal proteins with mesangial cells and during the course of APSGN.     

Detection and clinical usefulness of urinary interleukin-6 in the diseases of the kidney and the urinary tract.

Interleukin-6 (IL-6) plays a key role in inflammatory and immune responses in the host. In the present study, the IL-6 activity in urine from patients with various renal diseases was examined to elucidate the pathological and clinical significance of urinary IL-6. In patients with mesangial proliferative glomerulonephritis (mes-PGN) including, IgA nephropathy, the urinary IL-6 activity tended to increase with the progression of mesangial hypercellularity. In four patients with IgA nephropathy, urinary IL-6 activity increased markedly but transiently during episodes of acute exacerbation associated with upper respiratory tract infection. In addition, it was demonstrated that urine from patients with other types of PGN such as poststreptococcal acute glomerulonephritis and membrano-proliferative glomerulonephritis contained large quantities of IL-6. However, the levels of urinary IL-6 activity were almost within the normal range in non-proliferative glomerular diseases such as membranous nephropathy, minimal change nephrotic syndrome and lupus nephritis (WHO class I and V), non-glomerular bleeding and orthostatic proteinuria. It should be noted that a marked increase in urinary IL-6 was often observed in the patients with urinary tract infection. These results indicated that IL-6 in urine might be derived from various types of cells participating in inflammatory reactions not only in the renal parenchyma but also in the urinary tract.     

Extrarenal cytokines modulate the glomerular response to IgA immune complexes.

Clinical episodes of IgA nephropathy coincide recurrently with microbial infections. Cytokines produced during such infections may play a role in the pathogenesis of IgA-associated glomerulonephritis. To test this hypothesis, we examined the influence of passively administered proinflammatory cytokines (IL-1, IFN-gamma and IL-6) on the development of glomerulonephritis in an experimental model of IgA nephropathy. Glomerular IgA immune deposits were induced in mice by administration of IgA anti-phosphorylcholine (PC) with either a PC-containing carbohydrate antigen of Pneumococcal C polysaccharide (PnC) or a protein antigen of PC-conjugated bovine serum albumin (PC-BSA). The effect of IL-1 on the IgA-PC-BSA induced glomerular changes resulted in an increase of mesangial hypercellularity that was associated with mild proteinuria and hematuria. Mice treated with IL-1 and IgA-PnC developed diffuse proliferative glomerulonephritis with proteinuria and hematuria. In contrast, IL-6 treatment with IgA-PC-BSA of IgA-PnC failed to exert any significant renal effect. The combination of IL-6 and IL-1, however, intensified the mesangial hypercellularity of the IgA-PC-BSA, and induced severe proliferative glomerulonephritis with inflammatory monocytes and neutrophils infiltrates in the IgA-PnC treated mice. These glomerular changes were also accompanied by increased proteinuria and hematuria. Similarly, the combination of IFN with IL-1 produced histologic changes and compromised renal function more than IFN or IL-1 exerted independently. These results suggest that extrarenal cytokines influence the renal response to IgA immune deposits. We also conclude that a synergy of multiple cytokines and nephritogenic antigens immobilized in glomerular IgA immune deposits may lead to rapid progression of IgA-associated glomerulonephritis.     

Glomerulonephritis in diabetic patients and its effect on the prognosis

Renal biopsies were obtained from 164 patients with diabetes mellitus. Their histological changes were evaluated together with clinical findings and prognosis. In 36 patients, various types of glomerulonephritis were complicated: mesangial proliferative glomerulonephritis (17 patients), membranous glomerulonephritis (8), endocapillary proliferative glomerulonephritis (5), membranoproliferative glomerulonephritis (4) and minimal change nephrotic syndrome (2). Superimposed glomerulonephritis was suspected in diabetic patients with a short history of less than 5 years, persistent proteinuria, occasional hematuria and no retinopathy. They may, however, produce little effects on the long-term prognosis of diabetic patients except membranoproliferative glomerulonephritis.