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目的初步探讨狼疮肾炎(LN)患者肾间质中肥大细胞(MCs)与肾间质纤维化之间的关系。方法随机选取Ⅲ、Ⅳ、V型LN患者各10例作为研究对象,微小病变病(MCD)患者11例作为对照组。采用免疫组织化学、免疫荧光双重染色方法观察肾组织中类胰蛋白酶(Try)染色阳性MCs、蛋白酶活化受体-2(PAR-2)、转化生长因子-β1(TGF-β1)及I型胶原(Col I)表达的变化。结果 3个LN组肾间质MCs数量、肾小管上皮细胞PAR-2和TGF-β1及肾间质Col I表达面积均较MCD对照组明显升高,其中Ⅳ型LN组上述4项指标增加最明显,Ⅲ型LN组次之。MCs数量与肾小管上皮细胞PAR-2、TGF-β1及肾间质Col I阳性染色面积呈显著正相关;肾小管上皮细胞PAR-2与TGF-β1阳性染色面积间呈显著正相关;MCs数量与肾间质PAR-2和TGF-β1阳性染色细胞数量分别呈显著正相关;PAR-2阳性染色细胞数量和TGF-β1阳性染色细胞数量间也呈显著正相关;肾间质中Try阳性染色细胞与PAR-2或TGF-β1 阳性染色细胞存在部分重叠。结论 MCs可能参与LN肾间质细胞外基质蓄积,推测可能与释放Try、活化PAR-2、增加TGF-β1表达相关。
Objective To investigate the relationship between mast cells (MCs) and renal interstitial fibrosis in patients with lupus nephritis (LN). Methods A total of 10 patients with type Ⅲ, Ⅳ and V LN were randomly selected as study subjects and 11 patients with minimal change disease (MCD) as control group. Immunocytochemistry and immunofluorescence staining were used to observe the expression of trypsin-positive MCs, PAR-2, TGF-β1 and collagen type I in renal tissue (Col I) expression changes. Results The number of renal interstitial MCs, the expression of PAR-2 and TGF-β1 in renal interstitium and the expression of Col I in renal interstitium were significantly higher in the three LN groups than those in the MCD control group Obviously, type Ⅲ LN group followed. There was a significant positive correlation between the number of MCs and the area of positive staining of PAR-2, TGF-β1 and Col I in renal tubular epithelial cells. There was a significant positive correlation between the number of MCs and the area of positive staining of TGF-β1 in renal tubular epithelial cells. There was a significant positive correlation between the number of PAR-2-positive cells and the number of positive staining cells of PAR-2 and TGF-β1 in renal interstitium. The number of PAR-2 positive cells was also positively correlated with the number of TGF- Cells partially overlap with PAR-2 or TGF-β1-positive cells. Conclusion MCs may be involved in extracellular matrix accumulation in LN renal interstitium, which may be related to the release of Try, activation of PAR-2 and increase of TGF-β1 expression.