HBV感染与IgA肾病肾小管-间质病变的关系

目的 探讨ＩｇＡ肾病ＨＢＶ感染与肾小管间质病变的关系。方法 利用原位分子杂交（ＧＨＢＶ ＤＮＡ）、免疫组化（ＨＢＡｇ、ＣＤ３、ＣＤ８）以及ＨＢＶ ＤＮＡ－ＨＢＡｇ和ＨＢＡｇ－ＣＤ４３双标记技术,对９１例ＩｇＡ肾病肾穿刺标本进行研究。结果 肾组织内ＨＢＡｇ阳性率为６９．２％。ＨＢＶ ＤＮＡ原位杂交阳性率为４２．９％。ＨＢＶ ＤＮＡ阳性的病例,双重标记染色发现ＨＢＶ ＤＮＡ阳性肾小管上皮细胞可表达ＨＢ

The relationship between HBV infection and injury of tubuli and interstitium in IgA nephropathy

OBJECTIVE: To clarify the correlation between HBV infection and the injury of tubuli and interstitium of IgA nephropathy. METHODS: Renal biopsy specimens from 91 patients with primary IgA nephropathy were investigated by use of in situ hybridization (HBV DNA), immunohistochemistry (HBsAg, HBcAg, CD3, CD8) and HBV DNA, HBAg-CD43 double staining techniques. RESULTS: The positive rate of HBAg in renal tissue as detected by immunohistochemistry was 69.2% and that of HBV DNA detected by in situ hybridization was 42.9%. Double staining showed that HBV DNA positive tubular epithelial cells might coexpress HBsAg and/or HBcAg. The numbers of the infiltrated CD3+ cells and CD8+ cells in cases with positive HBV infections markers were significantly higher than those of cases without infection (P < 0.01). In addition, CD43+ T lymphocytes infiltrated around or invaded into the tubuli walls which had positive HBcAg or HBsAg expression. CONCLUSION: After HBV infection, the renal cells could express HBAg and induce infiltration of CD3+ cells and CD8+ cells, resulting in aggravation of the injury of tubuli and interstitium. Therefore, it is considered that HBV infection might play an important role in the occurrence and progress of IgA nephropathy.