Gremlin在原发性肾小球疾病患者肾小管间质中的表达及其意义

目的探讨原发性肾小球疾病患者肾小管间质中Gremlin的表达及其意义。方法采用免疫组化法检测63例原发性肾小球疾病患者及9例正常肾组织穿刺标本中Gremlin、转化生长因子（TGF）-β1，及a-平滑肌肌动蛋白的表达，并用计算机图像分析软件检测肾小管间质Gremlin、TGF—β1及a-SMA阳性染色相对面积，同时检测原发性肾小球疾病患者血肌酐和尿素氮。结果与对照组比较，原发性肾小球疾病患者肾小管间质Gremlin、TGF-β1。及a-SMA表达均明显增加（P〈0．05）；原发性肾小球疾病患者小管间质Gremlin表达阳性率随小管间质纤维化损害程度增高而增加（P〈0．05），并与TGF-β1，及a—SMA表达呈正相关（r=0．583、0．596，P均〈0．05）；肾小管间质Gremlin表达阳性率与患者血肌酐、尿素氮水平呈正相关（r=0．802、0．708，P均〈0．05）。结论Gremlin表达与原发性肾小球疾病肾间质纤维化程度密切相关，它可以作为原发性肾小球疾病肾间质纤维化程度的一个标志。

Expression and significance of Gremlin in renal tubulointerstitium of patients with primary glomerular disease

Objective To investigate the expression and significance of Gremlin in renal tubulointerstitium of patients with primary glomerular disease. Methods The expressions of Gremlin,TGF-β1 and a- SMA in renal biopsy specimens from 63 patients with primary glomerular and 9 normal controls were analyzed by immunohistochemistry. The relative positivestained areas of Gremlin, TGF-β1 and a-SMA were scored by computer-assisted image analysis software, meanwhile the serum creatinine and blood urea nitrogen of patients with primary glomerular were determined. Results Compared with control group, the expression of Gremlin, TGF-β1 and a-SMA increased significantly in renal tubulointerstitium in primary glomerular groups （P 〈 0.05）. The expression of Gremlin in interstitial was positively correlated with the degree of tubulointerstitial injury（ P 〈 0. 05 ）. There were significantly positive correlations between Gremlin expression and TGF-β1 ,a-SMA, serum creatinine and blood urea nitrogen（ r =0. 583,0.596,0.802 and 0.708 espeetively,P 〈 0.05 ）. Conclusions Gremlin expression was strongly correlated with the degree of renal interstitial fibrosis in primary glomerular disease,which may be a marker of the degree of renal interstitial fibrosis.