NLRP3炎性体在糖尿病肾病肾间质炎症反应中的作用

目的 探讨NLRP3炎性体在糖尿病肾病肾间质炎症反应中的作用。 方法 选择2014年6月-2015年5月浙江省人民医院2型糖尿病肾病患者50例作为糖尿病肾病组,同期肾脏错构瘤手术切除患者50例作为对照组。比较2组患者的临床资料、尿IL-18和尿IL-1β水平、肾小管上皮细胞NLRP3、P2X4、IL-18和IL-1β的表达,分析糖尿病肾病肾间质炎症和肾小管上皮细胞NLRP3、P2X4、IL-18和IL-1β表达的相关性,糖尿病肾病肾小管上皮细胞NLRP3、P2X4免疫组化表达评分和尿IL-18、IL-1β水平的相关性。 结果 糖尿病肾病组的尿蛋白定量、空腹血糖、甘油三酯、总胆固醇和低密度脂蛋白均高于对照组(P<0.05)。糖尿病肾病组尿IL-18和尿IL-1β水平均高于对照组(P<0.05)。糖尿病肾病组肾小管上皮细胞中NLRP3、P2X4、IL-18和IL-1β呈高表达,对照组肾小管上皮细胞中NLRP3、P2X4、IL-18和IL-1β呈低表达或不表达。糖尿病肾病组肾小管上皮细胞NLRP3、P2X4、IL-18和IL-1β的表达评分均明显高于对照组(P<0.05)。糖尿病肾病肾间质炎症和肾小管上皮细胞NLRP3、P2X4、IL-18和IL-1β表达均呈正相关(P<0.05)。糖尿病肾病肾小管上皮细胞NLRP3、P2X4免疫组化表达评分和尿IL-18、IL-1β水平均呈正相关(P<0.05)。 结论 P2X4可能通过激活NLRP3炎性体,调控炎性细胞因子,引起糖尿病肾病肾间质炎症反应。 

Effect of NLRP3 inflammasome on diabetic nephropathy renal interstitial inflammation

Objective To explore the effect of NLRP3 inflammasome on diabetic nephropathy renal interstitial inflammation. Methods From Zhejiang provincial people's hospital type 2 diabetic nephropathy,50 patients were selected as diabetic nephropathy group,kidney hamartoma surgery 50 patients as control group.The clinical data,urinary IL-18 and IL-1β levels,renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression were compared in two groups.The correlation between diabetic nephropathy renal interstitial inflammation and tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression,and the correlation between diabetic nephropathy renal tubular epithelial cells NLRP3,P2X4 immunohistochemical expression score and urine IL-18,IL-1β levels were analyzed. Results The urinary protein excretion,fasting blood glucose,triglycerides,total cholesterol and low density lipoprotein in diabetic nephropathy group were higher than that of control group (P<0.05).The urine IL-18 and urine IL-1β levels of diabetic nephropathy were higher than that of control group (P<0.05).The renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression of diabetic nephropathy group were high,the renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression of diabetic nephropathy group were low expression or not expression.The renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1βexpression scores of diabetic nephropathy group were significantly higher than that of control group (P<0.05).Diabetic nephropathy renal interstitial inflammation was positively correlated with tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression (P<0.05).Diabetic nephropathy renal tubular epithelial cells NLRP3,P2X4 immunohistochemical expression score were positively correlated with urine IL-18,IL-1β levels (P<0.05). Conclusion P2X4 possibly activates NLRP3 inflammatory body,regulate inflammatory cytokines,and causes diabetic nephropathy renal interstitial inflammation.