狼疮肾炎患者肾组织CD40及其配体表达的免疫组织化学分析

目的　探讨CD40 CD40配体 (CD40L)相互作用在狼疮肾炎 (LN)发病机制中的可能作用。方法　用免疫组织化学方法对 2 0例LN患者肾组织CD40和CD40L的表达进行检测 ,并对其与肾脏病变的相关性进行分析。结果　Ⅲ、Ⅳ型LN肾组织CD40表达较正常对照组显著上调 (P <0 0 1) ,除系膜细胞、内皮细胞和肾小管上皮细胞CD40表达增强外 ,还出现CD40阳性的间质浸润细胞。Ⅲ、Ⅳ型LN患者肾组织CD40L表达亦显著增强 (P <0 0 1) ,其分布范围与CD40一致。Ⅱ、Ⅴ型LN患者肾组织CD40表达范围和强度与正常肾组织大致相似。LN肾组织CD40表达与病变活动指数相关 (r =0 78,P <0 0 1)。结论　CD40 CD40L在肾脏局部的相互作用可能在LN发生和发展中起重要作用。

Immunohistologic analysis of renal CD40 and CD40 ligand expression in lupus nephritis

Objective To investigate potential mechanisms by which CD40-CD40ligand (CD40L) interaction may be involved in the pathogenesis of lupus glomerulonephritis (LN).Method Renal in situ CD40 and CD40L expression was examined in 20 LN patient biopsy specimens by immunohistochemical method.The relationship between CD40 expression and renal pathologic changes was analyzed.Results Compared with normal kidney,glomerular and tubular CD40 expression was markedly up-regulated in class Ⅲ and class Ⅳ LN,where there was intense staining of crescents,proximal and distal tubules,and interstitial mononuclear cells (P＜0.01).The distribution and expression intensity of CD40L in class Ⅲ and class Ⅳ LN were similar to those of CD40.In contrast,CD40 expression in class Ⅴ and class Ⅱ LN was similar to that in normal kidney.The CD40 expression in renal tissue had relativity with the disease active index (r＝0.78,P＜0.01).Conclusion The interaction of CD40 and CD40L in kidney may play an important role in the pathogenesis of LN.