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目的 探讨CD40 CD40配体 (CD40L)相互作用在狼疮肾炎 (LN)发病机制中的可能作用。方法 用免疫组织化学方法对 2 0例LN患者肾组织CD40和CD40L的表达进行检测 ,并对其与肾脏病变的相关性进行分析。结果 Ⅲ、Ⅳ型LN肾组织CD40表达较正常对照组显著上调 (P <0 0 1) ,除系膜细胞、内皮细胞和肾小管上皮细胞CD40表达增强外 ,还出现CD40阳性的间质浸润细胞。Ⅲ、Ⅳ型LN患者肾组织CD40L表达亦显著增强 (P <0 0 1) ,其分布范围与CD40一致。Ⅱ、Ⅴ型LN患者肾组织CD40表达范围和强度与正常肾组织大致相似。LN肾组织CD40表达与病变活动指数相关 (r =0 78,P <0 0 1)。结论 CD40 CD40L在肾脏局部的相互作用可能在LN发生和发展中起重要作用。
Objective To investigate the possible role of the interaction of CD40 CD40 ligand (CD40L) in the pathogenesis of lupus nephritis (LN). Methods Immunohistochemistry was used to detect the expression of CD40 and CD40L in renal tissue of 20 LN patients and their correlations with renal lesions were analyzed. Results The expressions of CD40 in type Ⅲ and type Ⅳ LN were significantly higher than those in normal control group (P <0.01). In addition to the increased expression of CD40 in mesangial cells, endothelial cells and renal tubular epithelial cells, CD40-positive interstitial infiltrating cells . The expressions of CD40L in renal tissues of type Ⅲ and type Ⅳ LN patients were also significantly increased (P <0.01), and their distribution range was consistent with that of CD40. The range and intensity of expression of CD40 in renal tissues of patients with type ¢ ò and ¢ ñ LN were similar to that of normal renal tissues. The expression of CD40 in LN renal tissue correlated with the activity index (r = 0 78, P 0 01). Conclusion The local interaction of CD40 CD40L in the kidney may play an important role in the occurrence and development of LN.