摘要
目的探讨协同刺激因子Ｂ７介导的免疫反应在药物性间质性肾炎和ＩｇＡ肾病间质损伤发生中的作用。方法应用免疫组织化学方法对药物性间质性肾炎，ＩｇＡ肾病伴肾小管间质损伤（ＩｇＡＮ）患者和正常人肾组织中协同刺激因子Ｂ７－１和Ｂ７－２，ＨＬＡ－ＤＲ抗原以及ＣＤ４＋和ＣＤ８＋细胞的分布进行了观察和分析。结果间质性肾炎患者肾间质ＣＤ４＋和ＣＤ８＋细胞浸润明显增加，表达Ｂ７－１和Ｂ７－２的细胞显著增多，同时伴肾小管上皮细胞ＨＬＡ－ＤＲ和Ｂ７－１表达的增加。ＩｇＡＮ患者肾间质中ＣＤ４＋和ＣＤ８＋细胞较正常人增多，表达Ｂ７－１的细胞无明显差异。肾小管上Ｂ７－１的表达有所增加，但ＨＬＡ－ＤＲ的表达不增加。结论药物性间质性肾炎和ＩｇＡＮ患者肾小管及间质免疫损伤的表现形式及发生机理存在着差异。
Objective To evaluate the role of costimulatory B7 molecules in the pathogenesis of drug induced interstitial nephritis(D TIN) and IgA nephropathy with severe tubulointerstitial injury(IgAN).Methods Renal biopsy materials from D TIN(n=15) and IgAN(n=15) were used. Cadaveric donors for kidney transplantation(n=10) served as normal controls.The lymphocyte subsets and the expression of B7 1, B7 2 and HLA DR in the renal tissue were analyzed by immunohistochemistry staining. Results CD4 + and CD8 + cells in the interstitium markedly increased in patients with D TIN. Parallelly,B7 1 and B7 2 expressing cells in the interstitium also augmented in this group of patients.The expression of B7 1 and HLA DR on the renal tubular cells increased in patients with D TIN. Although CD4 + and CD8 + cells increased in the interstitium of IgAN,the B7 1 and B7 2 expressing cells in the interstitium were not different from those of the normal controls. Although the renal tubular expression of B7 1 was upregulated in IgAN,the expression of HLA DR kept in the normal range. Conclusion These results indicate that the costimulatory molecules mediated T cell activation plays an important role in the pathogenesis of D TIN. The interstitial infiltrating and tubular cells both act as an antigen presenting cells in the initiation of immune injury in D TIN. However, such evidence has not been found in patients with IgAN.
出处
《中华医学杂志》
CAS
CSCD
北大核心
1998年第7期517-519,共3页
National Medical Journal of China
基金
全军"九五"重点课题资助
