黏膜方对IgA肾病小鼠免疫学机制的影响

目的：探讨以中医和解清热立法组方的黏膜方治疗实验性IgA肾病的作用机制。方法：采用口服牛血清白蛋白（BSA）、尾静脉注射葡萄球菌肠毒素B（SEB）及腹腔注射免疫佐剂的方法诱发小鼠IgA肾病模型。随机分为正常组、模型组、中药组及对照组4组,观察治疗后各组尿蛋白、血清IgA及循环免疫复合物、肾组织肠组织IgA的表达、肾组织病理学的改变。结果：模型组小鼠尿蛋白和尿白蛋白较正常组增加,中药组较模型组尿蛋白降低;正常组肾脏无IgA沉积、肠黏膜IgA微弱表达,模型组肾脏有IgA沉积,其中主要是多聚IgA1（pIgA1）沉积、肠黏膜IgA强表达,各治疗组肾脏IgA沉积较模型组减弱、肠黏膜IgA强表达;各治疗组在肾组织中系膜细胞和系膜基质均较模型组明显降低（P〈0.01）,而中药组更优于对照组（P〈0.01）。结论：中药黏膜方能有效改善尿蛋白并抑制IgA沉积至肾小球系膜区,表明中医和解法能成为治疗IgA肾病的有效方法之一。

Research on Effects and Immunological Mechanism of IgA Nephropathy Mice Treated with Mucosa Decoction

Objective：To investigate the mechanism of experimental IgA nephropathy treated by mucosa decocation,which was selected of traditional clearing heat and reconciliation method. Methods：The model of IgA Nephropathy mice was induced by oral 0.1% BSA, intravenous SEB and intraperitoneal injection of immunoadjuvant. One hundred KM male mice were randomized into four groups： normal control group, IgAN control group, decoction control group and Fosinopril control group. To observe the changes of proteinuria,serum IgA,CIC, IgA expression at campylobacter and renal tissue,renal pathology after treatment. Results：Proteinuria of IgAN control group was increased than that of normal control group;and decoction control group was less than IgAN control group in urine protein. Non IgA deposition in the kidney and weak IgA expression in the campylobacter mucosa of normal control group; IgA （poly-IgA1 mainly） deposition in the kidney and strong IgA expression in the campylobacter mucosa of IgAN control group; IgA deposition in the kidney of each treatment groups was weaker and IgA expression in the campylobacter mucosa also was stronger than IgAN group;Mesangial cells？ and Mesangial matrix of treatment groups were obviously lower than that of IgAN control group （P 〈 0.01 ）, and the decoction group was better than Fosinopril control group yet（ P 〈 0.01 ）. Conclusion： Mucosa Decoction can improve Urine protein？ effectively and suppress IgA deposition in glomerular mesangial area, to show that traditional reconciliation method can be one of the effective methods in treating IgA nephropathy.