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目的 探讨原发性肾病 (PNS)外周血淋巴细胞 (PBLs)糖皮质激素膜受体 (mGR)表达及其与糖皮质激素 (GC)对淋巴细胞凋亡影响的关系。方法 2 0 0 2年 1月至 2 0 0 3年 8月徐州医学院附属医院对 18例PNS分为微小病变组 (MCNS)和非微小病变组 (NMCNS) ,另 10例正常儿童为对照组。分别以碘化丙啶染色法、流式细胞术及间接免疫荧光染色法分析PBLs凋亡率和mGR阳性细胞百分率 ,并观察临床GC治疗后尿蛋白转阴天数。结果 MCNS组PBLs的mGR表达高于NMCNS组及正常组 ,P <0 0 5 ;MCNS患儿空白组PBLs凋亡率低于NMCNS ,而其地塞米松组则高于NMCNS ,P <0 0 5 ;NMCNS与正常对照儿童空白及Dex组间无明显差异。MCNS组PBLs的mGR表达与 10 -7mol/LDex诱导其凋亡率呈正相关 ,而与临床GC治疗后尿蛋白转阴天数呈负相关。结论 两组PNS患儿mGR表达不同 ,GC对PBLs凋亡的影响亦不相同 ,MCNS组mGR表达增高及凋亡下调 ,而GC可诱导其凋亡上调。mGR可能参与了GC诱导PBLs凋亡的作用机制 ,且mGR表达的高低在某种程度上可能反映了患儿对GC敏感性的高低
Objective To investigate the expression of glucocorticoid membrane receptor (mGR) in peripheral blood lymphocytes (PBLs) of primary nephropathy (PNS) and its relationship with glucocorticoid (GC) on the apoptosis of lymphocytes. Methods From January 2002 to August 2003, 18 cases of PNS were divided into minimal change group (MCNS) and non-minimal change group (NMCNS), and the other 10 normal children were control group . The apoptosis rate of PBLs and the percentage of mGR positive cells were analyzed by propidium iodide staining, flow cytometry and indirect immunofluorescence staining, and the number of urine protein negative days after GC treatment was observed. Results The expression of mGR in PBLs in MCNS group was higher than that in NMCNS group and normal group (P <0.05). The apoptosis rate of PBLs in blank group was lower than that in NMCNS in MCNS group, and higher than that in NMCNS group in dexamethasone group (P <0.05) There was no significant difference between NMCNS and normal control children and Dex group. The mGR expression of PBLs in MCNS group was positively correlated with the apoptosis rate induced by 10 -7 mol / L Dex, but negatively correlated with the number of urine protein negative days after GC treatment. Conclusion The expression of mGR in two groups of children with PNS is different. The effect of GC on the apoptosis of PBLs is also different. The expression of mGR is increased and apoptosis is down-regulated in MCNS group, while GC can induce the up-regulation of apoptosis. mGR may be involved in the mechanism of GC-induced apoptosis of PBLs, and the level of mGR expression to some extent may reflect the level of GC sensitivity in children