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地塞米松对脓毒症新生大鼠nephrin的影响
引用本文:邹敏书,周建华,余健,何威逊,聂国明,罗莉漫,徐洪涛,丁冬胜,李琳.地塞米松对脓毒症新生大鼠nephrin的影响[J].临床儿科杂志,2012,30(4):367-371.
作者姓名:邹敏书  周建华  余健  何威逊  聂国明  罗莉漫  徐洪涛  丁冬胜  李琳
作者单位:1. 广州军区武汉总医院儿科,湖北武汉430070;华中科技大学同济医学院同济医院儿科,湖北武汉430030
2. 华中科技大学同济医学院同济医院儿科,湖北武汉,430030
3. 广州军区武汉总医院儿科,湖北武汉,430070
4. 上海交通大学附属上海儿童医院肾脏科,上海,200040
基金项目:湖北省自然科学基金资助项目
摘    要:目的观察脓毒症新生鼠肾小球足细胞裂孔隔膜蛋白nephrin、P-cadherin的表达及地塞米松对两者的影响,以探讨脓毒症蛋白尿的发生机制。方法新生10 d Wistar大鼠24只,采用脂多糖(LPS)腹腔内注射的方法诱导脓毒症模型,随机分为脓毒症组(SE组,n=12),地塞米松治疗组(DE组,n=12),DE组大鼠腹腔注射LPS 12 h后给予地塞米松0.3 mg/kg。另设出生10 d Wistar鼠为对照组(NC,n=10)。注射LPS 48 h后分别测定血清C-反应蛋白(CRP)、降钙素原(PCT)、中性粒细胞明胶酶相关载脂蛋白(NGAL),24 h尿蛋白(24 hUP)及尿足细胞(UPC)排泄水平;RT-PCR和Western-blotting检测肾小球nephrin、P-cadherin mRNA和蛋白质的表达。结果与NC组相比,SE组大鼠的CRP、PCT、NGAL、24 h UP水平均显著升高,差异有统计学意义(P均<0.01),UPC差异无统计学意义;nephrin、P-cadherin mRNA及蛋白质的表达明显下调。地塞米松明显改善LPS引起的CRP、PCT、NGAL、24 h UP升高,维持nephrin、P-cadherin mRNA及蛋白质的表达,对UPC的排泄无明显影响。结论地塞米松可减轻全身炎症反应,恢复肾小球nephrin、P-cadherin mRNA和蛋白质的表达,减轻蛋白尿。

关 键 词:地塞米松  脓毒症  nephrin  蛋白尿

Dexamethasone ameliorates the expression of nephrin in neonate rats with sepsis
ZOU Min-shu , ZHOU Jian-hua , YU Jian , HE Wei-xun , NIE Guo-ming , LUO Li-man , XU Hong-tao , DING Dong-sheng , LI Lin.Dexamethasone ameliorates the expression of nephrin in neonate rats with sepsis[J].The Journal of Clinical Pediatrics,2012,30(4):367-371.
Authors:ZOU Min-shu  ZHOU Jian-hua  YU Jian  HE Wei-xun  NIE Guo-ming  LUO Li-man  XU Hong-tao  DING Dong-sheng  LI Lin
Institution:1(1.Department of Pediatrics,Wuhan General Hospital of Guangzhou Command of PLA,Wuhan 430070,Hubei,China;2.Department of Pediatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China;3.Deparment of Nephrology,Children’s Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200040,China)
Abstract:Objective To observe the effects of dexamethasone on the expression of nephrin and P-cadherin at the slit diaphragm of the glomerular podocytes in neonate rats with sepsis,and investigate the mechanism of proteinuria in sepsis.Methods Twenty-four 10-day-old Wistar rats were intraperitoneally injected with a single dose of lipopolysac-charide(LPS)to induce sepsis model,and randomly divided into sepsis group(SE,n = 12)and SE plus dexamethasone treatment group(DE,n = 12).Rats in DE group were administrated dexamethasone(0.3 mg/kg)by intraperitoneal injection at 12 h after intraperitoneal injection of LPS.Another 10-day-old Wistar rats were served as control group(NC,n=10).At 48 h after LPS was intraperitoneally injected,serum C-reactive protein(CRP),procalcitonin(PCT),neutrophil gelatinase-associated lipocalin(NGAL),24 h urinary protein(24 h UP)and urinary podocytes(UPC)were measured.The expressions of glomerular nephrin and P-cadherin mRNA and proteins were detected by RT-PCR and Western-blotting respectively.Results CRP,PCT,NGAL and 24 h UP were significantly higher in SE group than those in NC group(P < 0.01),and UPC had no significant difference.The nephrin and P-cadherin mRNA and proteins expressions were decreased in SE group than those in NC group.Dexamethasone significantly reduced CRP,PCT,NGAL,24 h UP levels which were induced by LPS challenge,and preserved the expressions of nephrin and P-cadherin mRNA and proteins,but had no effect on the excretion of UPC.Conclusions Dexamethasone can ameliorate systemic inflammatory response,restore the expressions of glomerular nephrin and P-cadherin mRNA and proteins,and reduce proteinuria.
Keywords:dexamethasone  sepsis  nephrin  proteinuria
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