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目的分析狼疮肾炎(LN)患者尿液中受激活调节正常T细胞表达和分泌的因子(RANTES)水平与LN病变组织RANTES mRNA、核转录因子(NF-kB)p65 mRNA表达与活动性的相关性。方法选择2012年11月至2016年6月深圳龙岗区人民医院肾内科经治的22例系统性红斑狼疮(SLE)患者作为LN组,根据LN活动指数(AI)分为高、低活动组,选取10例肾功能正常的志愿者作为对照组,均测定尿液RANTES水平及肾组织RANTES mRNA、NF-kB p65 mRNA表达,分析其与患者尿RANTES水平及肾炎活动性的相关性。结果 LN组尿RANTES浓度高于对照组(P<0.05),高AI组尿RANTES水平、RANTES蛋白阳性细胞数、RANTES蛋白阳性小管数、RANTES mRNA相对表达量均高于低AI组(P<0.05),其NF-kB阳性细胞数、NF-kB p65蛋白阳性小管数、NF-kB p65 mRNA相对表达量、肌酐、24 h尿蛋白均高于LN低AI组与对照组(P<0.05);LN低AI组上述指标均高于对照组(P<0.05);尿RANTES与LN患者AI、RANTES mRNA、NF-kB p65 mRNA明显相关,以RANTES mRNA相关度最高(P<0.05)。结论尿RANTES与LN肾组织RANTES mRNA、NF-kB p65 mRNA呈正相关,可间接反映LN活动度。
Objective To analyze the correlation between the expression of RANTES and the expression of RANTES mRNA and NF-κB p65 mRNA in urine of patients with lupus nephritis (LN) . Methods From November 2012 to June 2016, 22 patients with systemic lupus erythematosus (SLE) treated by Department of Nephrology, People’s Hospital of Longgang District, Shenzhen were enrolled as LN group, and were divided into high and low activity groups according to LN activity index (AI) Ten volunteers with normal renal function were selected as the control group. The levels of RANTES in urine and the expressions of RANTES mRNA and NF-κB p65 mRNA in renal tissue were determined. The correlation between RANTES level and nephritis activity was analyzed. Results Compared with the control group, the urine RANTES concentration in LN group was significantly higher than that in control group (P <0.05). The levels of RANTES protein, RANTES protein positive cells, RANTES protein positive tubules and RANTES mRNA in high AI group were higher than those in low AI group ), The number of NF-kB positive cells, the number of NF-κB p65 positive tubules, the relative expression of NF-κB p65 mRNA, creatinine and 24 h urinary protein in LN group were significantly higher than those in LN group and control group (P <0.05); The LN, AI and AI in the low AI group were significantly higher than those in the control group (P <0.05). Urinary RANTES and LN in patients with LN were significantly correlated with AI, RANTES mRNA and NF-kB p65 mRNA, and RANTES mRNA was the highest (P <0.05). Conclusions Urine RANTES positively correlated with RANTES mRNA and NF-κB p65 mRNA in renal tissue, which indirectly reflected LN activity.