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目的研究转化生长因子β1(TGF-β1)和Ⅳ型胶原在慢性移植肾病(CAN)患者肾组织中的表达及意义。方法采用免疫组织化学技术及计算机图像分析系统,观测19例CAN患者移植肾组织中TGF-β1和Ⅳ型胶原的表达情况,分析两者间及与CAN病理分级之间的关系。结果CAN移植肾组织中TGF-β1和Ⅳ型胶原的表达比正常肾组织明显增加(P<0.001),并随CAN病理分级呈逐渐递增的趋势;与正常肾组织相比TGF-β1和Ⅳ型胶原在CAN患者肾小球和肾小管间质中的表达呈正相关(r=0.943,P<0.001及r=0.910,P<0.001)。结论Ⅳ型胶原的异常沉积是CAN患者移植肾纤维化的重要表现,TGF-β可能通过调控Ⅳ型胶原等成分的变化在CAN移植肾的纤维化进程中起重要作用。
Objective To study the expression and significance of transforming growth factor β1 (TGF-β1) and type Ⅳ collagen in renal tissues of patients with chronic allograft nephropathy (CAN). Methods Immunohistochemistry and computerized image analysis system were used to observe the expression of TGF-β1 and type Ⅳ collagen in 19 cases of CAN-treated renal allograft. The relationship between them and the pathological grade of CAN was analyzed. Results The expression of TGF-β1 and type Ⅳ collagen in CAN-grafted kidney tissue was significantly higher than that in normal kidney tissue (P <0.001), and gradually increased with the pathological grade of CAN. Compared with normal kidney tissue, TGF- The expression of collagen in the glomeruli and tubulointerstitium of CAN patients was positively correlated (r = 0.943, P <0.001 and r = 0.910, P <0.001). Conclusions The abnormal deposition of collagen type Ⅳ is an important manifestation of renal graft fibrosis in CAN patients. TGF-β may play an important role in the process of fibrosis of CAN-grafted kidney by regulating the changes of collagen type Ⅳ and other components.