TLR9、Mcp-1在狼疮肾炎患者肾组织中的表达及临床意义

目的 探讨toll样受体9(TLR9)、单核细胞趋化蛋白1(Mcp-1)在狼疮肾炎(LN)肾组织中的表达及临床意义.方法 选择46例LN患者(病理分型:Ⅲ型12例,Ⅳ型23例,Ⅴ型11例)和12例正常对照的肾组织.采用免疫组化SP法检测TLR9、Mcp-1在肾组织的表达,通过Image-Pro Plus6.0图像分析法对表达定量化,比较各组间差异,分析各组表达量与临床实验室指标的相关性.结果 TLR9、Mcp-1在狼疮组表达量显著高于对照组(P<0.05).在狼疮组内Ⅳ型表达最高,Ⅴ型次之,Ⅲ型最少.其主要表达于肾小管间质,少量表达于肾小球,且表达量与24 h尿蛋白、肾小管间质病理评分、SLEDAI评分呈正相关性(P<0.05),与血清C3呈负相关性(P<0.05),与血肌酐、估算肾小球滤过率无明显相关性.结论 TLR9、Mcp-1在LN肾组织中的表达显著高于对照组,与疾病的发生发展密切相关,可能作为治疗LN的新靶点.

Expression and clinical significance of TLR9 and Mcp-1 in renal tissue of patients with lupus

Objective To investigate the expression and clinical significance of Toll-like receptor 9(TLR9) and monocyte chemoattractant protein-1(Mcp-1) in renal tissue of lupus nephritis.Methods 46 cases of patients with lupus nephritis(LN) and normal control 12 cases were chosen(including 12 cases of pathological type Ⅲ,23 cases of type Ⅳ and 11 cases of type Ⅴ).Immunohistochemistry streptavidin-perosidase(SP) method was used to detect the expression of TLR9 and Mcp-1 in renal tissue.Image-Pro Plus6 was used to analyze quantification and compare the differences among all groups.The Linear correlation between the expression levels and clinical laboratory indexes were analyzed.Results The expression of TLR9 and Mcp-1 in lupus group was significantly higher than that in control group(P<0.05).In lupus,the expression of type Ⅳ was the highest.Type Ⅴ was less than type Ⅳ.Type Ⅲ was the least.TLR9 and Mcp-1 were mainly expressed in renal tubular interstitium and slightly expressed in glomerulus.The expression of Mcp-1 in lupus group was consistent with TLR9.The tubulointerstitial TLR9 and Mcp-1 in SLE group were positively correlated with 24 h urine protein,renal tubular pathology scores,and SLEDAI scores(P<0.05),but negatively correlated with serum C3(P<0.05).However,it had no significant correlation with serum creatinine and estimated glomerular filtration rate.Conclusion The renal tubular interstitial expression of Mcp-1 and TLR9 in LN is significantly higher than the control group.The expression is closely related to the occurrence and development of lupus nephritis disease.TLR9/Mcp-1 signaling pathway may be served as a new target for the treatment of LN.