摘要
目的探讨肾脏组织中血小板反应蛋白1(thrombospondin-1,TSP-1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)在肾间质纤维化发生、发展中的表达及意义。方法选择不同类型肾脏疾病患者53例,按肾间质病理损伤程度对肾组织标本进行分组:正常对照组5例、轻度损伤组18例、中度损伤组19例、重度损伤组11例。用免疫组织化学技术和计算机真彩色图像分析系统半定量检测肾间质的TSP-1、VEGF、CD34、TGF-β1、α-SMA和Ⅳ型胶原表达情况。结果在正常对照组,TSP-1无阳性表达;TGF-β1在肾小管上皮细胞浆偶见表达;α-SMA仅在血管壁表达;肾间质Ⅳ型胶原在肾小管基底膜、动脉管壁呈线状表达。而VEGF在肾小管上皮细胞及足突细胞浆均可见表达,CD34在肾小管周围毛细血管内皮细胞表达。随着病变程度加重,TSP-1、TGF-β1、α-SMA和Ⅳ型胶原其表达量及面积显著增加(P<0.01),与肾间质病理损害程度呈显著正相关(r=0.86,0.674,0.779,0.784)。而VEGF及CD34表达量及面积则显著递减(P<0.01),与肾间质病理损害程度呈显著负相关(r=-0.715,-0.672)。结论随着肾间质病理损伤程度加重,TSP-1在肾小管上皮细胞、肾间质区表达增强,与肾间质损害程度呈显著正相关;VEGF在肾小管上皮细胞、足细胞表达减弱,与肾间质损害程度呈显著负相关。提示TSP-1与VEGF对肾小管周围毛细血管作用失衡,使肾小管周围毛细胞血管减少,加重肾组织缺氧,导致慢性肾间质纤维化发生、发展。
Objective To elucidate the association of renal tubulointerstitial expression of TSP-1（thrombospondin-1） and VEGF （vascular endothelial growth factor） with renal disease in the patients with chronic nephropathy and to evaluate the role of TSP-1 and VEGF in the genesis of chronic renal interstitial fibrosis. Methods The expression of TSP-1, VEGF, CD34 , TGF-β1 , α-SMA, and type Ⅳ collagen in renal tissue were investigated with immunohistochemistry assay and computer image analysis system in 53 patients with chronic kidney disease. According to the score of the renal interstitial pathology injury, fifty three patients were di- vided into four groups： 5 patients in none injury group（ the normal control group）, 18 patients in light injury group, 19 patients in middle injury group, llpatients in severe injury group. Results TSP-1 was not detected in normal control group, TGF-β1 ,α-SMA and type IV collagen were rarely detected in normal control group,and the expression increased gradually in other groups with the degree of renal interstitial pathological injury （P〈0. 01）. A significant positive correlation was found between the expression of TSP-1 ,VEGF, CD34, TGF-β1 , α-SMA, and type Ⅳ collagen and the degree of renal tubulointerstitial pathological injury（r= 0. 86, 0. 674, 0. 779,0. 784 respectively）. The expression of VEGF and CD34 was the strongest in tubular epithelial cells and peritubular capillaries respectively in normal control group, and decreased gradually with the degree of renal interstitial pathological injury （P≤0.01）, and a significant negative correlation was found between the expression of VEGF and CD34 and the degree of renal tubulointerstitial pathological injury（r= -0. 715, -0. 672, respectively）. Conclusion TSP-1 increased with the degree of the renal interstitial pathological injury. VEGF and CD34 both decreased gradually with the degree of renal interstitial pathological injury. The expression of TSP-1 was significantly positive correlated with the degree of renal interstitial pathological injury. The expression of VEGF was negatively correlated with the degree of the renal interstitial pathological injury. The disturbance of TSP-1 and / or VEGF decreased sums of peritubular capillaries and the degradation of ECM.
出处
《重庆医学》
CAS
CSCD
2007年第5期411-413,416,共4页
Chongqing medicine
