摘要
目的糖尿病肾病(diabetic nephropathy,DN)是慢性炎症性疾病。肥大细胞是多功能的免疫细胞,具有以多种方式参与DN发生发展的潜在能力。但目前尚未见有较全面的对肥大细胞与DN关系的分析和研究报道。文中研究在DN发生发展过程中肾组织中肥大细胞数量、活化水平的变化,及探讨肥大细胞与DN发生发展的相关性及可能病理作用。方法选取DN病例80例,其中早期19例、中期32例,晚期29例。同时选取正常供肾16例作为正常对照。以类胰蛋白酶作为肥大细胞标记分子,利用免疫组化的方法分析肾穿刺组织标本中肥大细胞的数量。以CD3、CD20、CD68分别作为肾组织T淋巴细胞、B淋巴细胞和巨噬细胞的标记分子,利用免疫组化染色方法分析肾穿刺组织标本中上述炎症细胞数量。根据肥大细胞周围的甲苯胺蓝异染颗粒及细胞内颗粒减少情况分析肥大细胞的脱颗粒反应,据以分析肾织织肥大细胞的活化水平。以此为基础分析肾组织中肥大细胞与DN临床病理指标的相关性。结果①在正常对照和DN患者的肾组织中肥大细胞主要分布于肾小管间质,肾小球中极少发现肥大细胞。DN患者的肾组织中,还可见肥大细胞侵入肾小管壁。②正常对照肾组织肥大细胞数量很少。在DN的肾组织中,肥大细胞数量随着病情发展而显著增加。③与正常对照相比,DN患者肾组织肥大细胞发生脱颗粒的比例显著增高,且表现为随DN进展而逐渐增加的趋势。④相关性分析显示,DN患者肾组织肥大细胞数量与肾功能损伤指标、小管间质损伤指标和炎症指标具有显著相关性。结论肥大细胞参与DN的发生发展过程,可能主要通过脱颗粒作用,释放细胞内的生物活性物质。肥大细胞在DN的肾小管间质损伤中发挥重要作用。肥大细胞可望成为DN防治的新靶标。
Objective This study was to observe the changes in the number and degranulation level of mast cells in the renal tissue of patients with diabetic nephropathy （DN） during the development of the disease and to explore the pathogenic role of mast cells. Methods We recruited in this study 80 patients at different clinical stages of DN and 16 normal kidney donors. We performed immunohistochemical staining for tryptase, CD3, CD20 and CD68, and toluidine blue staining on the renal sections of the patients and controls for examination of the changes in the number and degranulation level of mast cells. Then we analyzed the correlation between mast cells and the clinical and pathological indexes of the patients. Results Renal mast cells were found distributed mainly in the tubular interstitium in both normal controls and patients, few in the glomeruli, and occasionally infiltrated in the wall of the atrophy tu- bulus. Only a few renal mast cells were observed in the normal control group, but their number was increased with the development of DN. And the degranulation rate of mast cells, too, was increased with the development of DN, as compared with that in the normal controls. The increased number and degrannlation level of mast cells were significantly correlated with renal function injury, tubular interstitial injury and tubular interstitial inflammation indexes. Conclusion Mast cells are involved in the development of diabetic nephropathy, mainly through releasing bioactive substances into tubular interstitium by degranulation. Mast cells play an important role inrenal tubular interstitial injury and promise to be a new target in the prevention and treatment of diabetic nephropathy.
出处
《医学研究生学报》
CAS
北大核心
2012年第6期622-627,共6页
Journal of Medical Postgraduates
