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目的:观察一种新发现的血管生成相关生长因子血管生成素样蛋白2(ANGPTL2)在糖尿病肾病(diabeticnephropathy,DN)肾小球中的表达特征,并对其在DN发生发展过程中可能的作用机制进行初步探讨。方法:采用肾活检组织肾小球微分离技术结合半定量RTPCR方法,观察24例2型DN患者肾小球中ANGPTL2mRNA表达情况,以8例移植供肾活检组织作正常对照。并将其表达水平与DN患者临床病理指标进行相关分析。结果:DN患者肾小球ANGPTL2表达阳性率显著高于对照组(95%vs38%,χ2=15.9,P<0.01)。在表达明显上调(>2倍)的患者中,肾小球微血管瘤、内皮细胞炎性浸润与泡沫化变性的发生率明显少于其他患者(22%vs66%;11%vs73%;11%vs53%;P<0.05)。结论:ANGPTL2是一种血管生成相关的内皮细胞生长调节因子,参与DN微血管病变的发生机制。该因子在糖尿病肾小球中表达的上调可能是内皮损伤与血管重构过程中的一种应激性反应,具有维持内皮细胞功能与毛细血管正常结构的保护性作用。
AIM: To observe the expression of a newly discovered angiogenin-like growth factor-angiogenin-like protein 2 (ANGPTL2) in diabetic nephropathy (DN) glomerular and its possible role in the development and progression of DN Mechanism to conduct a preliminary discussion. Methods: The renal glomerular microdissection combined with semi-quantitative RT-PCR method was used to observe the expression of ANGPTL2 mRNA in glomeruli of 24 patients with type 2 DN. Eight patients with renal biopsy were used as normal control. The correlation between the expression level and clinicopathological parameters of DN patients was analyzed. Results: The positive rate of ANGPTL2 expression in glomeruli of DN patients was significantly higher than that of the control group (95% vs38%, χ2 = 15.9, P <0.01). The incidence of glomerular capillary hemangiomas, endothelial inflammatory infiltration and foam degeneration was significantly lower in patients with significantly higher (> 2-fold) expression (22% vs. 66%; 11% vs 73%; 11% vs 53 %; P <0.05). Conclusion: ANGPTL2 is an angiogenesis-related endothelial cell growth regulator that participates in the pathogenesis of DN microangiopathy. The upregulation of this factor in diabetic glomerulus may be a stress reaction during endothelial injury and vascular remodeling, and has the protective effect of maintaining the function of endothelial cells and the normal structure of capillaries.