慢性移植肾肾病模型中骨桥蛋白、α平滑肌肌动蛋白和E钙黏蛋白的表达

目的 观察骨桥蛋白(OPN)、α平滑肌肌动蛋白(α-SMA)、E钙黏蛋白在大鼠慢性移植肾肾病(CAN)模型移植肾中的表达及其表达的相关性.方法 以Fisher大鼠为供者,Lewis大鼠为受者,进行原位异体肾移植(CAN组);以供、受者均为Lewis大鼠的肾移植模型作为对照.术后12周处死受者,取血、尿样本检测移植肾功能,取移植肾进行HE染色和天狼星红染色,观察其组织形态学变化.采用免疫组织化学法和免疫印迹法观察移植肾组织OPN、α-SMA和E钙黏蛋白的表达.结果 CAN组大鼠移植肾组织形态学符合CAN的病理改变.免疫组化结果显示,与对照组相比较,CAN组肾小管上皮及肾间质中OPN和α-SMA的表达增强,而CAN组小管上皮E钙黏蛋白的表达明显下降.免疫印迹结果与免疫组化结果一致,CAN组移植肾组织中OPN和α-SMA的表达相对灰度值分别为85.74±2.29和88.79±4.44,对照组分别为14.25±0.71、11.21±0.56,两组间的差异有统计学意义(P＜0.05).CAN组E钙黏蛋白的相对灰度值为24.96±0.02,对照组为75.04±3.21,两组间的差异有统计学意义(P＜0.05).两组大鼠移植肾OPN的表达量与α-SMA的表达量呈正相关(r=0.746,P＜0.05),与E钙黏蛋白的表达量呈负相关(r=-0.526,P＜0.05).结论 CAN大鼠移植肾中OPN的表达增加,OPN可能参与了移植肾肾小管上皮细胞向间充质细胞转化的过程.

Abstract：

Objective To investigate the expression of OPN, α-SMA, E-cadherin and their correlation in the chronic allograft nephropathy (CAN) rat model, and to explore the possible role of OPN in CAN.Methods Orthotopic renal-transplantation using Fisher rats as donors and Lewis rats as recipients was done to establish CAN group, and Lewis to Lewis rats as control group. Rats in each group were sacrificed 12 weeks after the surgery. Blood and urine were collected for further test. Allograft samples were collected and sectioned for HE, Sirus-red staining, immunohistochemistry and Western blot.Results There were CAN morphological changes of the allograft in CAN group. As compared with control group, immunohistochemistry and Western blot revealed that the expression of OPN and α-SMA in CAN group was significantly increased, and that of E-Cadherin reduced. Its trend was correlated with the inflammatory response and the EMT of tubule epithelial cells.Conclusions OPN expression in rat CAN model is significantly up-regulated. OPN may play a role in CAN. OPN might affect the CAN by promoting EMT of tubule epithelial cells.     

整合素连接激酶在大鼠慢性移植肾肾病中的作用与机制

目的探讨整合素连接激酶(ILK)在慢性移植肾肾病(CAN)中的作用与机制。方法实验组肾移植受者为雄性Lewis大鼠40只,供者为雄性F344大鼠40只,依照标准的慢性移植肾肾病大鼠模型要求行左肾原位移植。对照组分别为行单纯右肾切除的Lewis大鼠及F344大鼠各25只。于术后4、8、12、16及24周时分批处死大鼠,同时做肾功能与组织学检测,免疫组织化学与蛋白印迹法测定肾组织中ILK的表达,逆转录聚合酶链(RT-PCR)法检测ILK mRNA的表达,免疫组织化学方法检测基质金属蛋白酶9(MMP-9)的表达。结果CAN大鼠移植4周时肾间质可见单个核细胞浸润,12周时可见血管平滑肌细胞的移行与增殖,24周时可见轻度肾间质纤维化、血管硬化及管腔狭窄。CAN大鼠肾组织中ILK及ILK mRNA表达水平显著增高,且随着移植时间的延长有逐渐增高趋势。CAN大鼠肾移植术后8周前肾小管间质及肾小动脉MMP-9表达水平均显著高于同时段LEW对照组及F344对照组,16周后显著降低。Spearman等级相关分析结果显示:CAN大鼠肾组织中ILK表达水平与24 h尿蛋白定量、血清肌酐水平、肾间质单个核细胞浸润程度、肾小动脉平滑肌细胞数量、肾间质纤维化程度等呈显著正相关,与8周前MMP-9表达水平呈正相关,12周后无显著相关性。结论ILK在慢性移植肾肾病病理变化中发挥重要作用,移植早期肾小管间质及肾小动脉中MMP-9表达上调与ILK的作用机制有关。     

大鼠慢性移植肾肾病动物模型的制作经验总结

目的 总结制作稳定的大鼠慢性移植肾肾病(CAN)动物模型的经验.方法 以F344近交系大鼠为供者,取供者左肾作为供肾,原位低温灌注;以Lewis近交系大鼠为受者,行左侧原位肾移植,供肾动脉与受者腹主动脉端侧吻合,供肾静脉与受者肾静脉端端吻合,输尿管带膀胱瓣与受者膀胱吻合.术后用环孢素A灌胃10 d,剂量为10 mg·kg-1·d-1.每月采集受者血液和尿液,测定血肌酐及24 h尿蛋白,分别于术后2、4个月获取移植肾进行病理检查.结果 45只进行移植,手术成功率为85%,单次手术时间为(120±20)min.移植后1个月,大鼠即出现血肌酐、尿素氮及血胱抑素升高,24 h尿蛋白增加,与术前相比,各项指标均升高(P<0.05);术后2个月及4个月,除尿蛋白继续增加外,其余观察指标上升不明显.移植术后2个月,移植肾有轻度至中度的间质纤维化,淋巴细胞和浆细胞的浸润;4个月时,移植肾可见广泛的间质纤维增生,间质细胞大量浸润,肾小球基底膜增厚、硬化、闭塞,肾小管萎缩退化,符合CAN的病理改变.结论 通过充分的手术强化训练及改进,规范大鼠取、肾、移植术中、术后管理的每个细节,大鼠CAN模型的成功率及稳定性高.

Abstract：

Objective To summarize the experience of establishing the stable rat model of chronic allograft nephropathy. Methods We used Fisher rats as donors and Lewis rats as recipients.After the left kidney of the donor perfused in situ under hypothermic condition, the left renal vein,abdominal aorta and bladder flap of the donor was anastomosed with the left renal vein, renal artery and bladder of the recipient, respectively. The recipients were given cyclosporin oral solution 10 mg/kg every day by gavage for 10 days after transplantation. The blood and urine samples were collected 1 month, 2 months and 4 months after transplantation and renal function and total urine protein were examined. The pathological changes of the renal allograft were observed 2 and 4 months after transplantation. Results Forty-five rats received operation and achievement ratio was 85%. The renal transplantations were finished in 120 ± 20 min. The Scr, BUN, Cycs and total urine protein demonstrated a significant increase one month after transplantation. On the second and fourth month,with the exception of urine protein continued to increase, the other indicators did not change significantly. Two months after transplantation renal pathology demonstrated light to moderate interstitial fibrosis, infiltration of lymphocytes and plasma cells. At 4th month the renal allografts showed extensive interstitial fibrosis, a large number of infiltrating interstitial cells, thickening,hardening, occlusion of glomerular basement membrane, and renal tubular atrophy that were consistent with pathological changes of chronic allograft nephropathy. Conclusion Through adequate surgical training and improvement, and specification for rat nephrectomy, transplantation surgery,and postoperative management in every detail, the model with high success rate and stability can be achieved.     

Akt/蛋白激酶B信号传导通路在慢性移植肾肾病早期病变中的作用

目的探讨Akt／蛋白激酶B（PKB）信号通路在慢性移植肾肾病（CAN）早期病变中的作用。方法建立Fisher（F344）大鼠到Lewis（LEW）大鼠的左肾移植CAN模型，术后4、8、12及16周时测定24h尿蛋白定量及血肌酐水平，并进行移植肾组织学观察，免疫组化法检测移植肾组织中磷酸化Akt（p-Akt）及基质金属蛋白酶9（MMP-9）的表达，逆转录聚合酶链反应检测肾组织中p-Akt mRNA的表达水平。以单纯切除一侧肾脏的LEW大鼠和F344大鼠为对照。结果移植组术后各检测时间点的24h尿蛋白定量及血肌酐水平呈上升趋势（P〈0．05），其组织学改变的Banff评分也呈上升趋势（P〈0．05）。移植组各时间点的p-Akt及p-Akt mRNA表达水平均显著高于LEW对照组和F344对照组，且随时间的延长逐步增高（P〈0．05）；移植组MMP-9表达水平在术后4、8周显著高于LEW对照组和F344对照组（P〈0．05），术后16周显著低于LEW对照组和F344对照组（P〈0．05）。结论在CAN早期的肾组织中，p-Akt及MMP的表达上调，其表达水平与肾组织的病理改变程度呈正相关，它们可能在CAN早期的发生进展中发挥重要作用。     

Immune therapy with cultured microglia grafting into the injured spinal cord promoting the recovery of rat's hind limb motor function

Objective: To study the effect of activated microglia grafting on rats' hind limb motor function recovery after spinal cord injury.Methods: Microglia were separated from primary culture and subcultured for 3 generations. Lipopolysaccharide was added to the culture medium with the terminal concentrition of 10 μl/L for microglia activation 3 days before transplantation. Totally 80 adult Wistar rats were divided into transplantation group and control group, with 40 rats in each group. Spinal cord injury model of rats was set by hitting onto the spinal cord using a modified Allen impactor. With a 5 μl micro-syringe, the activated microglia suspension was injected into the injured area 7 days after the first operation. Basso, Beattie and Bresnahan (BBB) scoring for hind limb motor function was taken on the 1st, 7th, 14th, 21st, and 28th day after microglia transplantation, and 8 rats were sacrificed at each time point mentioned above, respectively. Frozen sections of the spinal cord were made for haematoxylin-eosin (HE) and Naoumenko-Feigin stainings. SPSS 11.0 software was used for statistical analysis.Results: BBB scores for hind limb motor function on the 14th, 21 st, and 28th day were significantly higher compared with the control group. Most liquefaction necrosis areas disappeared and only a few multicystic cavities surrounded by aggregated microglia remained in the transplantation group. Naoumenko-Feigin staining for microglia showed that the transplantation group had significantly more positive cells (P＜0.05).Conclusions: Grafting of activated microglia into the injured spinal cord can significantly promote the hind limb motor function recovery in rats with spinal cord injury and reduce the size of liquefaction necrosis area. The extent of lower limb motor function improvement has a positive correlation with the number of aggregated microglia.     

大鼠肝移植急性排斥反应中肿瘤坏死因子受体配体的表达及其意义

目的 观察肝移植排斥反应中移植肝脏内糖皮质激素诱导的肿瘤坏死因子受体配体(GITRL)的表达.方法 采用Kamada's二袖套法建立从Lewis到Brown Norway(BN)大鼠的肝移植排斥模型为排斥组(n=5),从BN到BN的肝移植模型为耐受组(n=5).术后24h,抽取血液,取肝脏及分离库普弗(Kupffer)细胞,检测肝脏上GITRL及肿瘤坏死因子(TNF)-α的表达,Kupffer细胞上GITRL的表达,检测血清及细胞上清液中TNF-α的表达.免疫组织化学染色强度采用Image-Pro Plus 6.0图像分析软件分析.结果 免疫耐受组和排斥组肝脏内的CITRL的平均染色强度分别为0.113±0.007和0.270±0.018(P＜0.05),TNF-α平均染色强度分别为0.114±0.004和0.141±0.005(P＜0.05),耐受组和排斥组的Kupffer细胞GITRL平均染色强度分别为0.206±0.017和0.337±0.018(P＜0.05),Kupffer细胞的培养上清液中,耐受组和排斥组TNF-α的值分别为(68.66±21.12)、(178.33±29.39)ng/L(P＜0.05).结论 在排斥的早期阶段肝脏及Kupffer细胞的GITRL表达增高,监测和干扰GITRL可能有益于肝移植急性排斥反应的早期诊断和处理.

Abstract：

Objective To investigate te changes of glucocorticoid induced tumor necrosis factor receptor ligand (GITRL) in hepatic allograft rejection. Methods Liver transplantation from Lewis rats (n = 5 ) to Brown Norway (BN) rats was performed by Kamada' s two-cuff technique as acute rejection group. Liver transplantation from BN to BN rats ( n = 5 ) was performed as tolerance group. Recipients were sacrificed at 24th h postoperation. Blood samples were collected and grafts were harvested, then Kupffer cells were isolated. GITRL and tumor necrosis factor (TNF)-α protein expression in the hver was tested by immunohistochemistry, and the GITRL expression in Kupffer cells by immunocytochemistry. Enzyme linked immunosorbent assay (ELISA) was employed to detect the changes of TNF-α protein in the serum and supernatant. The staining intensity was analyzed by Image-Pro Plus 6. 0 image analysis software. Results At 24th h postoperation, the liver GITRL expression levels in tolerance and rejection groups were 0. 113 ± 0. 007 and 0. 270 ±0. 018, respectively (P ＜0. 05). The TNF-α expression levels in the liver in tolerance and rejection groups were 0. 114 ± 0. 004 and 0. 141 ± 0. 005 respectively ( P ＜ 0.05 ). The GITRL expression levels in Kupffer cells in tolerance and rejection groups were 0. 206 ±0. 017 and 0. 337 ±0. 018 respectively (P ＜0. 05 ). As compared with tolerance group (68. 66 ±21.12) ng/L, TNF-α protein expression levels were up-regulated in the supernatant of rejection group ( 178.33 ± 29. 39 ) ng/L ( P ＜ 0. 05 ).Conclusion The expression of GITRL in the liver and Kupffer cells was increased in the early stage of rejection, and monitoring and interfering GITRL may be useful for the early diagnosis and management of an acute rejection in liver transplantation.     

磷酸化糖原合成酶激酶-3β在大鼠移植肾早期病理改变中的作用

目的 探讨糖原合成酶激酶-3β(GSK-3β)在大鼠移植肾早期病理改变中的作用.方法 以F344大鼠为供者,Lewis大鼠为受者,依照标准的慢性移植肾肾病(CAN)模型要求行左肾原位移植,制作CAN模型(移植组).术后7d切除受者的右肾.以切除一侧肾脏的雄性F344大鼠和Lewis 大鼠为对照(F344对照组和LEW对照组).分别于术后4、8、12、16及24周时收集24 h尿液,采集血液,测定24 h尿蛋白和血肌酐,取移植肾组织,观察组织学改变,并用免疫组化法检测肾组织中磷酸化GSK-3β表达.结果 移植组术后早期(4、8和12周)移植肾病理改变主要表现为单个核细胞浸润、血管平滑肌细胞(SMC)的移行增殖,在后期(16和24周)尿蛋白排泄率显著增高,移植肾病理改变表现为肾间质单个核细胞浸润明显增加及严重的肾间质纤维化、肾小管萎缩.移植组术后各时间点移植肾组织中磷酸化GSK-3β及其mRNA表达水平均显著低于LEW对照组和F344对照组相同时点的表达水平(P＜0.05),并随着移植时间的延长进一步降低.磷酸化GSK-3β表达水平与早期肾间质单个核细胞浸润程度、SMC移行增殖及后期肾间质纤维化、肾小管萎缩、血管硬化程度呈显著负相关.结论 磷酸化GSK-3β表达下调在大鼠移植肾早期的肾间质单个核细胞浸润、SMC移行增殖及后期的肾间质纤维化、肾小管萎缩、肾血管硬化病变的发生中均起重要作用.     

CTLA4-Ig对肝细胞移植大鼠免疫耐受的作用及其机制

目的 探讨细胞毒性淋巴细胞相关抗原4融合蛋白(CTLA4-Ig)诱导肝细胞移植大鼠免疫耐受的作用及机制.方法 10%D-氨基半乳糖(D-gal)一次性腹腔注射建立大鼠急性药物性肝衰竭模型;采用肝脏原位灌注法分离纯化肝细胞,经脾脏移植后随机分为两组.实验组腹腔一次性注射CTLA4-Ig,对照组不予处理.两组均分别于术后第1、3、5、7天采外周血观察白细胞介素(IL)-2、肿瘤坏死因子(TNF)及肝功能变化;术后1周测两组大鼠外周血T细胞亚群,处死大鼠后取脾脏苏木素-伊红(HE)染色.结果 实验组谷丙转氨酶(ALT)、血清总胆红素(TBil)于术后第7天分别为(6.5±7.3)IU/ml、(5.1±1.6)mmol/L,低于对照组.术后治疗组IL-2含量明显下降,第7天达到(1. 3138±0.8508)ng/L,两组差异有统计学意义(P＜0.05);术后TNF含量两组之间差异无统计学差异(P＞0.05).外周血CD4+T细胞、CD4+/CD8+T细胞实验组分别为(37.3±7.2)%、(1.5±0.1)%,低于对照组(P＜0.05),CD8+T细胞两组差异无统计学意义(P＞0.05).术后第7天治疗组脾内仍可见肝细胞或肝细胞团,对照组见大量淋巴细胞浸润,但很少见肝细胞.结论 CTLA4-Ig能诱导经脾同种异体肝细胞移植大鼠免疫耐受,使急性肝衰大鼠肝功能得到改善.可能是抑制T淋巴细胞亚群,且主要是抑制CD4+T细胞,使CD4+/CD8+T细胞比值下降;抑制IL-2的分泌.

Abstract：

Objective To investigate the immunosuppressive effect of cytotoxic T Iymphocyte associated antigen 4 Ig fusion protein (CTLA4-Ig) in rat allograft hepatocyte transplantation model and the mechanisms. Methods Acute liver failure (ALF) model was established by intraperitoneal injection of 10% D-gal solution to SD rates. Collagenase perfusion was performed on SD rats to separate liver cells. SD rats with ALF were subjected to intrasplenic hepatocyte transplantation and randomly divided into two groups. The experimental group received intraperitoneal injection of CTLA4-Ig. The concentrations of interleukin (IL)-2 and tumor necrosis factor (TNF), liver function and histologicy were observed at the 1st,3rd, 5th, 7th day after operation and the T lymphocyte subsets were detected by using immunohistochemistry at the 7th day after operation. Results The levels of ALT and TBil were respectively (6. 5 ±7.3) IU/ml and (5.1 ± 1.6) mmol/L at the 7th day after operation and significantly decreased after injection of CTLA4-Ig ( P ＜ 0. 01 ). IL-2 concentration in the experimental group was ( 1.3138 ± 0. 8508 ) ng/L at the 7th day after operation and significantly decreased (P ＜0. 05). TNF had no significant difference between two groups after operation ( P ＞ 0. 05 ). T lymphocyte subsets, mainly CD4 + , in the experimental group was significantly decreased as compared with control group ( P ＜ 0. 05 ), so did the CD4 +/CD8 +. Histological changes: At the 7th day after operation, there were some hepatocytes in the spleen of the experimental group. But in the control group, the changes in the spleen were characterized by severe lymphocyte infiltration. There were no hepatocytes both groups. Conclusion CTLA4-Ig can induce rat allogeneic hepatocytes intrasplenic transplantation immune tolerance. It may improve the liver function of rats with ALF.CTLA4-Ig can decrease T lymphocyte subsets, mainly CD4 + and concentrations of IL-2.     

大鼠肾移植后抗波形蛋白抗体升高与慢性移植肾肾病的相关性

目的 研究大鼠肾移植术后抗波形蛋白抗体的表达水平与慢性移植肾肾病(CAN)的相关性.以及不同免疫抑制剂对其的影响.方法 选取近交系F344大鼠作为同系肾移植的供、受者(共9对),选取F344和Lewis大鼠分别作为同种肾移植的供、受者(共27对).同系移植组受者术后不给予免疫抑制剂;同种移植组受者术后10 d内给予环孢素A(CsA),然后将同种移植组受者随机平均分为生理盐水(NS)组、CsA组和霉酚酸酯(MMF)组(每组9只),分别给予NS、CsA和MMF灌胃.术后第4、8和12周时分别处死每组受者3只,观察CAN的进展、波形蛋白及其基因的表达以及抗波形蛋白抗体的水平,取正常大鼠(包括F344和Lewis大鼠)作为对照.结果 观察期内同系移植组未发生CAN;而同种移植组发生了CAN,且不断加重,其中CsA组和NS组的CAN病理改变非常明显,而MMF组明显较轻.术前所有受者血清中均未检测到抗波形蛋白IgM和IgG抗体,术后也未检测到抗波形蛋白IgM抗体;术后同系移植组仅检测到微量的抗波形蛋白IgG抗体,同种移植组检测到大量的抗波形蛋白IgG抗体.随着CAN的进展,同种移植中,CsA组和NS组血清抗波形蛋白IgG抗体的水平逐渐增高,而MMF组抗体水平的增高显著低于NS组(P<0.05),但仍显著高于同系移植组(P<0.05).结论 大鼠同种肾移植术后,受者体内可产生抗波形蛋白IgG抗体,且产生的时间早于CAN,抗波形蛋白IgG抗体水平也会随着CAN的进展而增高.MMF可抑制抗波形蛋白IgG抗体的产生,CsA无此作用.     

SnoN蛋白在慢性同种移植肾病大鼠肾组织中的表达及作用

目的：观察Smad核转录共抑因子（SnoN蛋白）在慢性移植肾病（CAN）大鼠肾组织的表达及其与CAN大鼠肾脏功能改变、病理学改变、Smad泛素化调节因子2（Smurf2）之间的关系,探讨SnoN蛋白在CAN中的作用。方法：实验组采用近交系大鼠的同种异基因动物间的左肾原位移植,雄性F344大鼠40只为供体,雄性LEW大鼠40只为受体,移植手术后第10天行右肾切除术,对照组采用单肾切除术的雄性大鼠25只。分别于4周、8周、12周、16周及24周处死大鼠,做肾功能、移植肾组织学检测,并借助免疫组织化学与免疫印迹、逆转录-多聚酶联反应方法检测肾组织中snoN蛋白、snoNmRNA的表达;免疫组织化学与免疫印迹方法检测肾组织smurf2的表达,免疫印迹方法检测肾组织p-smad2/3蛋白的表达水平,逆转录-多聚酶联反应方法检测肾组织TGF-β1mRNA的表达。结果：移植组大鼠尿蛋白定量、血清肌酐水平于移植后16周时显著增高,24周时更为显著。snoN蛋白在移植组逐渐降低,24周时降至最低,为对照组的13%。snoNmRNA在移植组和对照组差异无统计学意义;p-smad2/3、smurf2在移植后随疾病进展逐渐升高,24周时达高峰。免疫组织化学结果显示snoN蛋白表达部位、表达时相与smurf2是一致的。相关分析显示,肾移植大鼠snoN蛋白表达水平与24h尿蛋白定量、血清肌酐水平、肾间质纤维化程度呈负相关（P〈0.05,P〈0.01）。与smad2/3、smurf2水平呈显著负相关（P〈0.01）。结论：SnoN蛋白表达下调在CAN发病机制中起作用,同时Smurf2介导SnoN蛋白降解可能参与了这个过程。     

大鼠慢性同种移植肾病肾组织中Smad7的表达及意义

目的研究大鼠慢性同种移植肾病肾组织中Smad7的表达及意义。方法制作原位肾移植大鼠模型，分别于4周、8周、12周、16周及24周处死大鼠，检测24h尿蛋白定量、肾功能；移植肾组织标本切片行光镜检测；免疫组织化学与免疫印迹、逆转录-多聚酶链反应方法检测肾组织中Smad7蛋白、Smad7mRNA的表达；免疫印迹方法检测肾组织p-smad2／3蛋白的表达水平，逆转录-多聚酶链反应方法检测肾组织转化生长因子-81mRNA的表达。结果移植组大鼠尿蛋白定量、血清肌酐水平于移植后16周时显著增高，24周时更为显著。Smad7蛋白在移植组逐渐降低，24周时降至最低，为对照组的15％。Smad7mRNA在移植后4周即升高，随着移植时间逐渐延长，24周时为对照组的2．73倍（P〈0．01）；p-smad2／3在移植后随疾病进展逐渐升高，24周时达高峰。免疫组织化学结果显示Smad7主要表达在小管间质。相关分析显示，肾移植大鼠Smad7蛋白表达水平与24h尿蛋白定量、血清肌酐水平、肾间质纤维化程度呈负相关（P〈0．05，P〈O．01）。结论Smad7蛋白表达下调在慢性同种移植肾病发病机制中起重要作用。     

肾脏局部醛固酮对糖尿病肾病大鼠肾小管间质转分化的作用

目的 探讨醛固酮对糖尿病肾病（DN）大鼠肾小管间质转分化的影响。 方法 采用Wistar大鼠腹腔注射链脲菌素（STZ,60 mg/kg）制备糖尿病模型,4周后尿蛋白>30 mg/d为DN模型成功（n=16）,随机分为DN组（n=8）和螺内酯组（SP组,n=8）,以另8只正常大鼠作为对照组（N组）。SP组给予螺内酯40 mg&#8226;kg-1&#8226;d-1,N组、DN组每日以等量清水灌胃。8周后处死大鼠,收集尿、血浆、肾组织检测24 h尿蛋白定量、血肌酐和肾脏病理变化;用放射免疫法检测血浆、肾组织醛固酮浓度;用免疫组化、Western印迹方法检测E钙黏蛋白（E-cadherin）、α平滑肌肌动蛋白（α-SMA）蛋白的表达;用RT-PCR的方法检测E-cadherin、α-SMA mRNA的表达。 结果 与对照组比较,DN组尿蛋白排泄量、血肌酐均显著增加（均 P < 0.01）,肾组织E-cadherin蛋白和mRNA表达显著下调（均P < 0.01）,α-SMA蛋白和mRNA表达均显著上调（均P < 0.01）。DN组大鼠肾组织醛固酮显著升高[（24.71±5.30） ng/g比（16.38±2.85） ng/g,P < 0.01],与尿蛋白排泄量、血肌酐、α-SMA蛋白表达呈正相关（r = 0.737、0.574、0.688,均P < 0.05）,与E-cadherin蛋白表达呈负相关（r = －0.659,P < 0.01）。各组间血清醛固酮含量差异无统计学意义。与DN组比较,SP组大鼠尿蛋白排泄和血肌酐显著下降（均P < 0.01）,E-cadherin蛋白和mRNA表达上调（均P < 0.05）,而α-SMA蛋白和mRNA表达显著下调(均P < 0.01)。 结论 DN大鼠肾组织局部醛固酮参与了糖尿病肾病肾间质转分化,螺内酯可以阻断醛固酮与其受体结合,抑制肾小管间质转分化,从而起到肾脏保护作用。     

Lisinopril suppresses the endoplasmic reticulum stress associated tubular cell apoptosis induced by proteinuria in adriamycin nephropathy

Objective To investigate the role of endoplasmic reticulum stress in tubular epithelial cell apoptosis in chronic proteinuria rat model and the effect of lisinopril intervention. Methods Adriamycin nephropathy was induced in male Wistar rats (n=12) by a single injection of adriamycin at 2 mg/kg body weight. Rats were then randomly assigned to model group or treatment group, to which distilled water or lisinopril were administered respectively for 12 weeks. Six normal rats serving as controls were administered distilled water. 24 h urine samples were collected at week 4, 8, 12 and the urine protein was measured. At the end of study, serum was obtained and physiological parameters (serum creatinine, urea, total protein and albumin) were measured. Renal tubular epithelial cell apoptosis was assessed by TUNEL. GRP78, CHOP protein expression in kidney was quantified by immunohistochemistry and Western blotting. Results Compared to control group rats, increased proteinuria was observed in model group rats at week 4, 8, 12 (P＜0.05). Lisinopril treatment attenuated urine protein excretion significantly (P＜0.05). At week 12, hypoalbuminemia was detected in model group rats (P＜0.05), whereas the condition was alleviated by lisinopril (P＜0.05). There were no significant differences of serum creatinine, urea and total protein in each group (P＞0.05). Compared to control group rats, increased TUNEL positive tubular epithelial cells and tubular GRP78 and CHOP expression were also observed in model group rats (P＜0.05); however, these conditions in the kidney were significantly decreased in treatment group (P＜0.05). Conclusions Endoplasmic reticulum stress may be involved in the process of tubular epithelial cell apoptosis induced by proteinuria. Lisinopril may attenuate tubular epithelial cell apoptosis through regulating this signal pathway.     

Potential function of angiopoietin-like protein 3 in hyperlipidemia of nephrotic syndrome

Objective To explore whether angiopoietin-like protein 3 (Angptl3) is involved in the development of hyperlipidemia in nephrotic syndrome. Methods PCR analysis was carried out to identify the genotypes of Angptl3 Knockout mice. Sixty newborn Angptl3 knockout (KO) mice and wild type (WT) mice were randomly divided into four groups: KO-ADR, KO-Saline, WT-ADR and WT-Saline group. In each group 6 mice at different time points were separately analyzed: the pre-molding, molding 1st, 2nd, 4th, 8th week. WT-ADR and KO-ADR groups were treated with 25 mg/kg ADR once via tail vein injection at day 0; WT-saline and KO-saline groups were injected with the same volume of saline. Automatic biochemical analyzer was employed to test serum cholesterol (Cho) and triglycerides (TG) levels, ELISA method to detect the urine protein and urine creatinine, and real-time fluorescence quantitative PCR to detect the expression of Angptl3 mRNA in the renal tissue. Results (1)There were no significant differences in the weight, morphology or function of the liver and kidney between the KO and WT mice. Compared with WT mice, the levels of Cho and TG obviously decreased in the KO mice (P＜0.01). (2) In the WT-ADR group, urinary protein levels and the levels of Cho and TG increased significantly at 1st week after ADR injection (P＜0.05), while serum albumin level decreased dramatically (P＜0.05). The serum levels of Cho and TG increased gradually during the entire study period. The expressions of Angptl3 mRNA in kidney tissues were up-regulated significantly from 1st week (P＜0.05) to 8th weeks(P＜0.01). Furthermore, the expression of Angptl3 mRNA was significantly positively correlated with the Cho and TG levels (r=0.885, P＜0.01; r=0.788, P＜0.01, respectively). (3)The levels of Cho and TG in the Angptl3-/- mice were lower than those in the WT mice during the entire study period after ADR injection (P＜0.05). Conclusions Angptl3 is involved in the development of hyperlipidemia in nephrotic syndrome. Knocking-out of Angptl3 may play an anti-dyslipidemic role in nephrotic syndrome.     

Role of C3a and C5a in focal segmental glomerulosclerosis

Objective To study the role of C3a and C5a in focal segmental glomerulosclerosis (FSGS) patients. Methods (1) A total of 66 patients with FSGS confirmed by renal biopsy were selected, including 18 cases of tip lesion, 11 cases of perihilar, 22 cases of not otherwise specified (NOS), 10 cases of cellular, and 5 cases of collapsing FSGS. The normal renal tissue resected from patients with kidney tumor was taken as a negative control. The expression of C3a and C5a in renal tissues was detected by immunohistochemistry. (2) Serum and urine samples from these 66 FSGS patients were collected, and serum and urine samples from 10 healthy adult selected from the same physical examination center in the same term were used as normal controls. The levels of C3a and C5a in serum and urine were detected by enzyme-linked immunosorbent assay (ELISA). Results (1) Immunohistochemical results showed that C3a and C5a were deposited in glomerulus of FSGS patients, and no deposition in normal renal tissues. The semi-quantitative score showed that kidney C3a score was significantly correlated with serum creatinine (r=0.547, P＜0.001) and 24 h urine protein (r=0.329, P=0.007) in FSGS patients, and kidney C5a score was also significantly correlated with serum creatinine (r=0.415, P＜0.001) and 24 h urine protein (r=0.414, P＜0.001) in FSGS patients. (2) The levels of serum C3a and C5a in FSGS patients were higher than those in healthy adults (both P＜0.05), but there was no significant difference among the five pathological types (P＞0.05). The levels of urinary C3a/urinary creatinine, urinary C5a/urinary creatinine were higher in FSGS patients than those in healthy adults (all P＜0.05). The levels of urine C3a/urinary creatinine and urinary C5a/urinary creatinine in collapsing FSGS were higher than other FSGS types (all P＜0.01), but there was no significant difference among the tip lesion, the perihilar, the not otherwise specified and the cellular (P＞0.05). (3) Urinary C3a/urinary creatinine levels were significantly correlated with serum creatinine (r=0.774, P＜0.001) and 24 h urine protein (r=0.430, P＜0.001) in FSGS patients, and urinary C5a/urinary creatinine levels were also significantly correlated with serum creatinine (r=0.677, P＜0.001) and 24 h urine protein (r=0.333, P=0.007) in FSGS patients. Conclusion Complement C3a and C5a may be involved in the pathogenesis of FSGS and may be related to the severity of FSGS.