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协同刺激因子B7在药物性间质性肾炎和IgA肾病间质损伤中的作用 |
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刘志红 宦红娣 王金泉 周虹 黎磊石
（210002 南京军区总医院中国人民解放军肾脏病研究所）
【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。
【关键词】 肾炎，间质性 肾小球肾炎，IgA
Costimulatory B7 molecules in drug induced interstitial nephritis and IgA nephropathy with tubulointerstitial injury Liu Zhihong, Huan Hongdi, Wang Jinquan, et al. Institute of Nephrology, Jinling Hospital, Nanjin University School of medicine Nanjing, 210002
【Abstract】 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 a[1] [2] [3] 下一页
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