热休克蛋白47在2型糖尿病肾病中的表达及其意义

目的:探讨热休克蛋白47( heat shock protein 47,HSP47)在2型糖尿病肾病(diabetic nephropathy,DN)中的表达及其意义.方法:45例2型DN患者分为DN组25例和轻微病变性肾病(MCD)组20例.使用常规病理组织学方法观察肾小球、肾小管间质和血管的病变程度,免疫组织化学染色法观察各实验组肾组织内HSP47、α-平滑肌肌动蛋白(α-SMA)、波形蛋白(Vimentin)及Ⅳ型胶原(Col Ⅳ)的表达,并进行免疫双染共定位分析.结果:与MCD组比较,DN组肾小球内HSP47、α-SMA、Vimentin及Col Ⅳ表达明显增加(P＜0.05)；肾小管间质纤维化区域内HSP47、α-SMA及Col Ⅳ表达亦明显增加(P＜0.05),Vimentin则在肾小管间质内表达显著性增加(P＜0.01).免疫双染结果显示,DN组在增生硬化的肾小球系膜区及肾小管间质纤维化处,HSP47表达阳性细胞内同时有α-SMA阳性表达,并且HSP47表达阳性细胞同时具有Vimentin阳性表达.结论:HSP47过度表达或许通过帮助前胶原分子细胞内处理及加工,参与2型DN肾小球硬化及肾小管间质纤维化的形成.

Expression and significance of heat shock protein 47 in type 2 diabetic nephropathy

Objective:To investigate the expression and significance of heat shock protein 47(HSP47) on type 2 diabetic nephropathy(DN).Methods:In this study,the group of type 2 DN by renal biopsy were 25 cases.Meanwhile,20 cases of minimal change disease(MCD) diagnosed by renal biopsy specimens were selected as control group.Feature of renal histology was identified by light microscopy.The expression of HSP47,α-SMA,Vimentin and collagen type Ⅳ(Col Ⅳ) in type 2 DN and MCD groups were investigated by immunohistochemistry and double immunostaining co-localization analysis.Results: Compared with MCD group,the expression of HSP47,α-SMA,Vimentin and Col Ⅳ in glomeruli and tubulointerstitium of type 2 ND ground were significantly increased(P<0.05).Meanwhile,the expression of Vimentin in tubulointerstitium was significantly incresed(P<0.01).By double immunostaining,α-SMA positive cells were frequently found to co-express HSP47 in sclerosing glomeruli and fibrotic lesions of tubulointerstitium of type 2 DN.Increased expresson of Vimentin conincided with increased expression of HSP47 in sclerosin glomeruli and tubulointerstitial fibrosis from type 2 DN.Conclusion: Overexpression of HSP47 may by helping the excessive synthesis/assembly of procollagens,participate in glomerulosclerosis and tubulointerstitial fibrosis of type 2 DN.