IgA肾病患者肾组织中HBV DNA表达状况的研究

为了探讨乙型肝炎病毒(HBV)感染在IgA肾病发病中的作用，采用免疫组化技术检测12例IgA肾病患者肾组织中HBV抗原，同时应用Southern印迹杂交和原位分子杂交技术检测肾组织中HBV DNA的存在状态及定位情况。结果表明12例IgA肾病患者血清HBV感染标志至少一项阳性；肾组织中HBV抗原均阳性，其中HBcAg在肾小管和肾小球中阳性分别为8例和5例，HBsAg阳性分别为4例和6例；10例中有8例用Southern印迹杂交技术证实存在整合型HBV DNA；原位杂交技术证实12例患者肾组织HBV DNA均阳性，定位于肾小管上皮细胞核内，其中9例在肾小球系膜细胞核、上皮细胞核和基质中同时阳性。提示除了HBV抗原抗体复合物所致体液免疫损伤机制外，亦应考虑肾组织感染HBV导致的细胞免疫机制参与了IgA肾病的发病。

Study on HBV DNA state in renal tissue of IgA nephropathy

In order to investigate the role of hepatitis B virus (HBV) infection in the pathogenesis of IgA nephropathy (IgAN), HBV antigen (HBAg) in renal tissue of 12 IgAN patients were detected by immunohistochemistry techniques, the state and localization of HBV DNA were detected by Southern blot analysis and in situ hybridization. Results showed that in 12 patients with I-gAN, there were all cases with one or more HBV infectious markers in the sera; HBAg in renal tissues were all positive, HBeAg was found in tubular epithelia and glomeruli, respectively 8 and 5, HBsAg was 4 and 6; 10 of the 12 cases were proved to be HBV DNA positive by Southern blot analysis, all were of the integrated form; 12 specimens were all demonstrated to be HBV DNA positive by in situ hybridization, which was localized in the nucleus of tubular cells, in 9 cases HBV DNA were simultaneously detected in the nucleus of glomerular mesangial and epithelial cells as well as in the matrix. The results suggested that in addition to the humoral immune injury mediated by HBAg - HBAb immune complex, the cellular mechanism mediated by HBV originating from renal cells in situ may also involved in the pathogenesis of IgAN.