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目的:研究白细胞分化抗原CD34在IgA肾病肾小管间质病变中的表达变化,探讨其在IgA肾病进展过程中的作用。方法:应用免疫组织化学双标记技术检测不同小管间质病变程度的IgA肾病患者肾组织内CD34和α-平滑肌激动蛋白(α-SMA)的表达。肾小管间质病变分级采用Katafuchi积分。详细收集每例患者肾活检时的24h尿蛋白定量(TUPr)及内生肌酐清除率(Ccr),并与免疫病理结果进行相关分析。结果:无小管间质病变组未见CD34的表达,α-SMA仅表达于间质的动脉壁;轻度小管间质病变组CD34和α-SMA表达散在,主要见于小管间质受损部位;中、重度病变组较轻度病变组CD34和α-SMA的表达显著增加(P<0.05);小管间质内CD34的表达与α-SMA的表达及TUPr、Ccr具有显著相关性(P<0.05)。结论:随小管间质病变进展而出现的CD34表达增多可能在IgA肾病中发挥重要作用。
Objective: To investigate the expression of leukocyte differentiation antigen CD34 in tubulointerstitial lesions of IgA nephropathy and its role in the progression of IgA nephropathy. Methods: The expression of CD34 and α-smooth muscle actin (α-SMA) in renal tissue of IgA nephropathy patients with different tubulointerstitial lesions was detected by immunohistochemical double labeling technique. Tubular interstitial lesions were graded using Katafuchi points. The urinary protein quantitation (TUPr) and endogenous creatinine clearance (Ccr) of renal biopsy in each patient were collected in detail and correlated with the immunopathological results. Results: The expression of CD34 was not found in tubulointerstitial lesion group. Α-SMA was only expressed in the interstitial artery wall. The expression of CD34 and α-SMA in mild tubulointerstitial lesions was mainly found in the damaged part of tubulointerstitium. The expressions of CD34 and α-SMA in the moderate and severe lesions group were significantly increased compared with those in the mild lesions group (P <0.05). The expression of CD34 in the tubulointerstitium was significantly correlated with the expression of α-SMA and TUPr and Ccr (P <0.05) ). CONCLUSIONS: The increased expression of CD34 associated with tubulointerstitial lesions may play an important role in IgA nephropathy.