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目的测定IgA肾病患者外周血单个核细胞(PBMC)CD154的表达与NF-κB活化水平,在IgA肾病发生发展中的作用。方法对IgA肾病组进行肾活检计算肾小球横切面细胞数、损伤肾小管百分数及肾小球损伤指数。分离PBMC,采用流式细胞仪分析检测CD154的表达水平,免疫组化染色法测定NF-κBp65亚的单位活化水平。全自动生化分析仪测定血肌酐、24h尿蛋白定量、尿NAG。结果IgA肾病组PBMC CD154的表达水平(15.1±4.7)%、NF-κB活化水平(33.8±10.5%)均明显高于对照组(5.9±2.9)%、(3.5±1.3)%,P<0.01。患者PBMC CD154的表达水平与NF-κB活化水平、肾小球横切面细胞数,损伤的肾小管百分数及肾小球损伤指数、血肌酐、24h尿蛋白定量、尿NAG呈显著正相关(γ=0.475、γ=0.396、γ=0.538、γ=0.571(均P<0.01)、γ=0.308、γ=0.316、γ=0.324(均P<0.05)。结论IgA肾病患者PBMCCD154的表达水平显著升高,并与NF-κB活化水平、肾脏损伤指标密切相关,提示CD154在IgA肾病的发生发展中起到重要作用,与NF-κB的相互作用可能参与其对肾组织的作用。
Objective To determine the expression of CD154 in peripheral blood mononuclear cells (PBMC) and the activation of NF-κB in patients with IgA nephropathy and its role in the development of IgA nephropathy. Methods IgA nephropathy group renal biopsy calculated glomerular cross-section cell number, the percentage of injured tubules and glomerular injury index. PBMCs were isolated and the expression of CD154 was detected by flow cytometry. The activation level of NF-κB p65 subunit was determined by immunohistochemical staining. Automatic biochemical analyzer measured serum creatinine, 24h urinary protein, urinary NAG. Results The level of CD154 expression in PBMC of IgA nephropathy group was significantly higher than that of control group (15.1 ± 4.7%) and NF-κB activation level (33.8 ± 10.5%) (5.9 ± 2.9% vs 3.5 ± 1.3%, P <0.01) . The expression of CD154 in PBMC was positively correlated with the activation of NF-κB, the number of glomerular cross-section cells, the percentage of injured tubules and glomerular injury index, serum creatinine, 24-hour urinary protein and urine NAG (γ = 0.475, γ = 0.396, γ = 0.538, γ = 0.571 (all P <0.01), γ = 0.308, γ = 0.316 and γ = 0.324 (all P 0. 05) .Conclusion The expression of PBMC CD154 in patients with IgA nephropathy was significantly increased, It is closely related to the activation level of NF-κB and the index of renal injury, suggesting that CD154 plays an important role in the development of IgA nephropathy. The interaction with NF-κB may be involved in its role in renal tissue.