UUO幼年大鼠肾间质微血管损伤趋势及其相关分子特征

目的:探讨单侧输尿管结扎模型(UUO)幼年大鼠肾间质纤维化过程中局部微血管损伤趋势及其特征分子血小板反应蛋白(TSP-1)与血管内皮生长因子(VEGF)组织定位表达和时相表达的趋势、潜在的病理意义,并评价用血管紧张素转换酶抑制剂(ACEI)苯那普利干预的效应。方法:制备单侧输尿管结扎模型(UUO模型);分为正常对照组、UUO模型组、UUO模型治疗组;以术后第1、2、3、4周为时间点,取病变肾脏石蜡包埋并切片;HE染色评价肾组织常规病理变化,免疫组化方法检测大鼠肾组织CD34、TSP-1、VEGF的表达。用SPSS13.0统计软件进行统计学处理。结果:随试验时间的延长,CD34及VEGF在UUO模型组肾组织中表达量及面积显著减少(P0.01),TSP-1在UUO模型组肾组织中表达量及面积显著增加(P0.01),干预组这种变化趋势明显减缓。结论:在幼年大鼠梗阻性肾间质纤维化进展中,存在着肾间质微血管的损伤,这种损伤可能与VEGF和TSP-1对肾小管周围毛细血管调控作用失衡有关。早期应用ACEI干预可有效延缓肾间质纤维化的进程。     

水飞蓟素对单侧输尿管结扎大鼠肾组织TGF-β1及TSP-1表达的影响

目的 探讨水飞蓟素对肾间质纤维化的影响及其可能机制.方法 将36只雄性SD大鼠随机分为假手术组（C组）、模型组（M组）和水飞蓟素治疗组（S组）,各12只.对M组和S组大鼠建立单侧输尿管结扎（UUO）模型,C组仅分离左侧输尿管,未行结扎.S组大鼠给予水飞蓟素（50 mg/kg）灌胃.每组大鼠于术后第7、21天分别处死6只.观察各组大鼠肾组织病理学表现,采用RT-PCR方法检测各组大鼠肾组织转化生长因子β1（TGF-β1）和血小板反应蛋白1（TSP-1）mRNA表达水平.结果 术后第7天,M组大鼠肾组织出现肾小管明显扩张,偶见肾小管上皮细胞坏死、肾间质水肿、轻度纤维化,并有较多单个核细胞浸润;第21天,肾小管扩张进一步加重,并出现肾小管上皮细胞大量坏死,并可见肾间质大量胶原纤维组织增生,伴大量炎症细胞浸润;S组较M组肾组织损伤减轻,肾小管间质损伤指数降低（P〈 0.05）.术后第7、21天,M组TGF-β1和TSP-1 mRNA表达均较C组升高（P〈0.01）,S组TGF-β1和TSP-1 mRNA表达均较M组降低（P〈0.05）.结论 水飞蓟素可减轻肾组织损害,延缓肾间质纤维化的进展,可能与其抑制肾组织TSP-1及TGF-β1的表达有关.     

慢性马兜铃酸肾病血小板反应因子1高表达与肾间质纤维化及微血管丢失的关系

目的 探讨血小板反应因子1（TSP-1）与慢性马兜铃酸肾病（CAAN）肾间质纤维化及肾小管周围毛细血管（PTC）丢失的关系。方法 36只SD大鼠被随机分为CAAN模型组（用关木通浸膏水溶液间断灌胃）及对照组（仅自来水灌胃），每组18只。分别于第4、8和12周处死6只大鼠，用肾组织切片做免疫组化染色。对TSP-1、转化生长因子-β1（TGF-β1）、氨基肽酶P（APP）、血管内皮生长因子（VEGF）及Ⅰ型胶原（ColⅠ）的表达进行半定量分析。结果 与对照组比较，模型组大鼠肾间质TSP-1、肾小管TGF-β1及肾间质Col Ⅰ表达均显著上调（P均〈0．01）。3者间表达量呈显著正相关（r=0．925、0．910、0．857，P均〈0．01）。模型组大鼠肾间质APP表达明显下调（P〈0．01），与TSP-1、Col Ⅰ表达量呈显著负相关（r=-0．945、-0．883，P均〈0．01）。模型组肾小管VEGF表达上调（P〈0．01），其表达量与APP呈显著负相关（r=-0．607，P〈0．01），而与TGF-β1星显著正相关（r=0．625，P〈0．01）。结论 TSP-1-TGF-β轴表达增强及与TSP-1相关的PTC丢失均可能参与CAAN肾间质纤维化，而VEGF表达上调为代偿表现。     

N-乙酰基-丝氨酰-天门冬酰-赖氨酰-脯氨酸对肾间质纤维化大鼠MCP-1及NF-κB表达的影响

目的：观察N-乙酰基-丝氨酰-天门冬酰-赖氨酰-脯氨酸（AcSDKP）对单侧输尿管梗阻（UUO）所致大鼠肾间质纤维化的的保护作用并初探其机制。方法：雄性Wistar大鼠18只,随机分为假手术组、UUO组、治疗组（AcSDKP＋UUO）,每组各6只。于造模第14天处死大鼠,取其梗阻侧肾脏组织行HE、Masson染色,光镜下观察肾组织病理改变,评价肾小管变性程度及肾间质纤维化指数,免疫组织化学检测各组肾脏组织MCP-1、ED-1及NF-κB蛋白表达,RT-PCR检测MCP-1 mRNA的表达,Western blot检测NF-κB的蛋白质表达。结果：与假手术组相比,UUO组大鼠肾脏肾小管变性及肾间质纤维化程度严重,AcSDKP治疗后可明显改善UUO组大鼠肾小管变性和间质纤维化（P〈0.05）;免疫组化染色显示：MCP-1、ED-1及NF-κB的蛋白表达UUO组和治疗组明显多于假手术组,但治疗组较UUO组明显减少（P〈0.05）;AcSDKP治疗组MCP-1 mRNA及NF-κB蛋白质的表达均显著弱于UUO组,二者相比差异有统计学意义（P〈0.05）。结论：AcSDKP通过抑制NF-κB激活并进一步减少下游炎症细胞因子的表达以达到治疗肾间质纤维化的作用。     

动员自体骨髓干细胞对大鼠急性肾小管坏死的治疗

目的：观察粒细胞集落刺激因子联合干细胞因子动员骨髓干细胞的作用、骨髓干细胞是否具有向损伤肾组织归巢的能力及其在肾脏组织中的分布,初步探讨粒细胞集落刺激因子联合干细胞因子是否具有促进急性肾小管坏死修复的作用。方法：160只8～10周龄雄性SD大鼠随机分为4组：对照组,模型组、G-CSF＋SCF治疗组、G-CSF＋SCF对照组,检测：（1）外周血白细胞总数及单个核细胞中CD34＋细胞百分比的变化;（2）尿NAG酶检测;（3）肾脏组织病理学改变;（4）肾组织CD34＋细胞表达变化。结果：（1）G-CSF＋SCF治疗组和G-CSF＋SCF对照组外周血中白细胞数、CD34＋细胞百分比于第5天达高峰,与对照组、模型组相比,差异有统计学意义（P〈0.05）,以后逐渐下降;相应地,G-CSF＋SCF治疗组肾组织内CD34＋细胞较对照组、模型组也明显增多（P〈0.05）。（2）手术后第5、10、17天,G-CSF＋SCF治疗组尿NAG酶、肾脏病理学改变均明显好于模型组（P〈0.05）。第24天G-CSF＋SCF治疗组尿NAG酶、肾脏病理学改变基本恢复正常,而模型组仍异常。第31天各组间尿NAG酶、肾脏病理学改变其差异无统计学意义。结论：（1）粒细胞集落刺激因子和干细胞因子联合应用对缺血再灌注损伤诱发急性肾小管坏死大鼠的骨髓干细胞有显著的动员作用。（2）骨髓干细胞能在损伤的肾小管归巢和定居,并可能参与损伤肾组织的修复。（3）粒细胞集落刺激因子和干细胞因子联合应用能在一定程度上加速急性肾小管坏死后肾功能的修复。     

血小板反应蛋白-1及其受体CD47在肾间质纤维化血管病变中的表达

目的观察血小板反应蛋白-1(TSP-1)及其受体CD47在单侧输尿管梗阻(UUO)大鼠模型中的表达,探讨TSP-1-CD47在肾周毛细血管(PTC)病变中的作用。 方法将60只SD大鼠随机分为2组：UUO组45只和假手术组(SOR) 15只。UUO组随机选取15只分别于术后3 d、7 d、14 d处死;SOR组随机选取5只于相同时间点处死。检测24 h尿蛋白定量,采用全自动生化分析仪检测各组大鼠的肾功能,通过Masson染色观察肾间质病理改变;免疫荧光双染色观察TSP-1及其受体CD47在UUO模型中是否存在共表达。Western印迹检测毛细血管病变指标CD34和血管内皮生长因子(VEGF)及TSP-1的表达;多组间均数比较使用方差分析;TSP-1与CD34、VEGF的相关性进行Pearson相关分析。 结果与SOR组相比,UUO各组大鼠血清肌酐、尿素氮、24 h尿蛋白定量随梗阻时间延长无明显变化,但肾间质纤维化逐渐加重,肾小管损伤评分增加。免疫荧光双染色显示TSP-1及其受体CD47在肾小管间质存在共表达。Western印迹检测显示随UUO时间延长,TSP-1蛋白水平逐渐增加,而CD34及VEGF蛋白表达随梗阻时间延长逐渐下降。相关分析显示TSP-1蛋白水平与CD34及VEGF的表达呈负相关(r＝－0.931, P<0.01;r＝－0.953, P<0.01)。 结论TSP-1及其受体CD47在UUO大鼠模型肾间质存在共表达,且与PTC呈负相关。TSP-1可能通过CD47参与UUO肾脏PTC病变的发生发展。     

热休克蛋白47在单侧输尿管梗阻大鼠肾小管上皮细胞转分化中的作用

目的:研究热休克蛋白47在单侧输尿管梗阻大鼠肾小管上皮细胞转分化(EMT)中的作用,探讨以HSP47为靶点防治肾脏间质纤维化的策略。方法:采用UUO大鼠模型,雄性SD大鼠72只随机分为假手术组(Sham组)、UUO模型组(UUO组)、UUO模型+超声联合脂质微泡+HSP47反义寡核苷酸组(antisenseODNs组)以及UUO模型+超声联合脂质微泡+HSP47正义寡核苷酸组(senseODNs组),每组18只,于术后14 d处死各组大鼠。HE和Masson染色法观察各组大鼠肾脏病理改变,Western blotting及Real-time PCR方法检测HSP47、波形蛋白(Vimentin)、紧密连接蛋白(Zona occludens-1,ZO-1)及Ⅰ型胶原(Col-Ⅰ)的表达。结果:HE和Masson染色显示,与Sham组相比,UUO组大鼠肾间质宽度明显增加,肾小管扩张及上皮细胞变性,肾小管损伤程度、间质纤维化程度逐渐增加(P0.05)。与UUO组相比,antisenseODNs组病变程度较UUO组减轻(P0.05),senseODNs组无明显差别(P0.05)。Western blotting及Real-time PCR显示,与Sham组相比,UUO组HSP47蛋白及mRNA表达明显升高(P0.05),同时Vimentin、Col-Ⅰ蛋白及mRNA表达上调,而ZO-1蛋白及mRNA表达下调(P0.05);与UUO组相比,antisenseODNs组HSP47蛋白及mRNA表达明显降低(P0.05),同时Vimentin及Col-Ⅰ蛋白及mRNA表达下调,而ZO-1蛋白及mRNA表达上调(P0.05),纤维化程度明显减轻;senseODNs组HSP47、Vimentin、Col-Ⅰ、ZO-1蛋白及mRNA表达无明显变化(P0.05)。结论:UUO模型大鼠肾小管上皮细胞EMT过程中HSP47表达上调,抑制HSP47表达能部分逆转肾小管上皮细胞EMT。     

泽泻对单侧输尿管梗阻大鼠肾组织补体C_3及肾纤维化的影响

目的：探讨泽泻对单侧输尿管梗阻（unilateral uretreal obstructire,UUO）大鼠肾小管上皮细胞间充质转分化（epithelial-to-mesenchymal transition,EMT）的作用及其机制。方法：采用单侧输尿管梗阻方法制作大鼠肾间质纤维化模型。30只雄性SD大鼠随机分为假手术组、UUO组和泽泻治疗组。术前3d开始,泽泻治疗组给予中药泽泻9g·kg-1·d-1饮片溶于适量生理盐水中灌胃用。术后14d处死大鼠,观察梗阻侧肾组织病理损害和间质纤维化,免疫组化检测α-SMA、E-cadherin、补体成分C3在肾组织中的表达。结果：UUO组大鼠肾间质纤维化明显,泽泻干预后肾间质纤维化程度减轻。免疫组化结果表明UUO组大鼠C3和α-SMA表达明显增加,E-cadherin表达明显减少;泽泻干预后,C3和α-SMA的表达明显低于UUO组（P〈0.05）,E-cadherin的表达高于UUO组（P〈0.05）。结论：UUO大鼠肾小管上皮细胞的C3表达增加,中药泽泻能减轻UUO大鼠C3的表达,抑制肾小管上皮细胞EMT。     

单侧输尿管梗阻模型中微血管丢失机制的探讨

目的观察单侧输尿管梗阻（UUO）模型中微血管的丢失，探讨其可能的发生机制。方法48只雄性SD大鼠随机分为假手术组、UUO模型组各24只。两组大鼠分别于术后0、1、2、4w处死。取梗阻侧肾脏做Masson染色，免疫组化检测肾脏中CD31和血小板反应蛋白-1（TSP-1）的表达，用RT-PCR检测TSP-1、血管内皮生长因子（VEGF）mRNA水平的表达。结果①免疫组化显示CD31在假手术组各时点仅有较弱的表达；术后1w染色增强，术后2w表达减弱，术后4w表达缺失；TSP-1在假手术组各时点仅有较弱的表达；在模型组随时间表达持续增强。②RT-PCR结果显示VEGF mRNA假手术组各时点表达较弱；术后1w升高，术后2w和4w表达减弱；TSP-1mRNA水平在假手术组各时点表达较弱；在模型组表达持续升高。结论UUO模型中VEGF表达下调及TSP-1表达上调可能参与了其微血管的丢失。     

IgA肾病肾小管周围毛细血管的变化及临床意义

目的：探讨IgA肾病患者肾小管周围毛细血管与血管内皮细胞生长因子（VEGF）及其受体VEGF-R2（Flk-1）的表达变化及临床意义.方法：对24例不同病理改变的IgA肾病肾组织进行序列切片.采用免疫组织化学SP法检测肾小管间质中VⅢ因子、VEGF和Flk-1的表达.对各指标之间与临床病理改变之间进行相关分析.结果：IgA肾病患者肾组织中,肾小管间质中微血管密度在中度病变的病人表达最多,在重度者表达最少（P〈0.05）.VEGF主要表达于肾小管上皮细胞,Flk-1主要表达于肾间质中肾小管周围毛细血管内皮细胞.两者与肾小管周围毛细血管密度呈正相关（P〈0.05）.在中、重度组肾小管间质肾小管周围毛细血管的微血管密度与患者尿NAG酶的含量呈负相关（r=-0.57,P〈0.05）,与间质纤维化呈负相关性（r=-0.82,P〈0.01）.结论：IgA肾病肾小管周围毛细血管密度变化与肾小管间质的病变密切相关.血管内皮细胞生长因子可能是导致肾小管周围毛细血管密度变化的主要原因.     

Effect of intermedin on microvascular injury of unilateral ureteral obstruction rats

Objective To observe the effect of intermedin(IMD) on microvascular injury of renal fibrosis in unilateral ureteral obstruction (UUO) rat model. Methods Seventy-two male Wistar rats were randomly divided into two groups: the sham - operation group (n=24) underwent the left ureteral dissection, the other 48 rats were made as unilateral ureteral obstruction models and sub - divided into model group(UUO, n=24) and IMD group (n=24). At the 7, 14, 21, 28 day after the operation, 6 randomly - selected rats from each of the three groups respectively were blooded by abdominal arotic and their obstructive kidneys were taken out. The renal histopathological changes were observed through HE and Masson staining, the contents of BUN, Scr and cystatin C (CysC) of the obstructive kidneys were determined, the expressions of transforming growth factor - β1 (TGF - β1), α-SMA, bone morphogenetic protein-7 (BMP-7), E-cadherin, thrombospondin 1 (TSP-1) and vascular endothelial growth factor (VEGF) were detected by RT - PCR and immunohistochemistry. Results Compared with the sham-operated group, the pathological changes of kidney in the model group showed that the degree of fibrosis was obvious, tubular interstitial damage aggravated, the levels of BUN, Scr, CysC in the model group increased (P＜0.05), the mRNA expression and protein content of TGF-β1, α-SMA, TSP-1 increased (P＜0.05), while the levels of BMP-7, E-cadherin and VEGF decreased (P＜0.05). Compared with the UUO group, renal tubular damage, interstitial fibrosis in the IMD group were lighter, the levels of BUN, Scr, CysC in the IMD group were lower (P＜0.05), the mRNA expression and protein content of TGF-β1, α-SMA,TSP-1 were down-regulated (P＜0.05), while the levels of BMP-7, E-cadherin and VEGF were up-regulated (P＜0.05). Conclusion IMD can ameliorate the renal interstitial fibrosis, and the mechanism may be related to the fact that VEGF mediated by IMD can reduce vascular injury.     

参附注射液对单侧输尿管梗阻大鼠肾脏肝细胞生长因子表达的影响

目的：探讨单侧输尿管梗阻后大鼠肾间质纤维化发生过程中肝细胞生长因子（HGF）的表达及中药参附注射液对其的影响。方法：采用单侧输尿管结扎（UUO）制造梗阻性肾病模型，将56只大鼠随机分为对照组（假手术组）、手术组（UUO组）和治疗组（UUO＋参附），术后7d、14d观察肾组织病理改变，应用免疫组织化学方法检测肾组织中HGF的表达。结果：与对照组相比，手术组肾间质出现了明显的纤维化，HGF的表达在术后第7天明显增加，第14天较第7天减弱，与手术组相比，治疗组肾间质纤维化明显减轻，而且HGF的表达在术后第7天明显上调，第14天较第7天上调更明显，有统计学差异（P〈0．05）。结论：参附注射液可以上调肾组织HGF的表达，减轻肾小管一间质纤维化，发挥肾保护作用。     

Thrombospondin-1 plays a profibrotic and pro-inflammatory role during ureteric obstruction

Thrombospondin-1 (TSP-1) is an endogenous activator of transforming growth factor-β (TGF-β), and an anti-angiogenic factor, which may prevent kidney repair. Here we investigated whether TSP-1 is involved in the development of chronic kidney disease using rats with unilateral ureteral obstruction, a well-known model to study renal fibrosis. Obstruction of 10 days duration induced inflammation, tubular cell atrophy, dilation, apoptosis, and proliferation, leading to interstitial fibrosis. TSP-1 expression was increased in parallel to that of collagen III and TGF-β. Relief of the obstruction at day 10 produced a gradual improvement in renal structure and function, the reappearance of peritubular capillaries, and restoration of renal VEGF content over a 7- to 15-day post-relief period. TSP-1 expression decreased in parallel with that of TGF-β1 and collagen III. Mice in which the TSP-1 gene was knocked out displayed less inflammation and had better preservation of renal tissue and the peritubular capillary network compared to wild-type mice. Additional studies showed that the inflammatory effect of TSP-1 was mediated, at least in part, by monocyte chemoattractant protein-1 and activation of the Th17 pathway. Thus, TSP-1 is an important profibrotic and inflammatory mediator of renal disease. Blockade of its action may be a treatment against the development of chronic kidney disease.     

Impaired angiogenesis in the remnant kidney model: I. Potential role of vascular endothelial growth factor and thrombospondin-1.

Few studies have examined the role of the microvasculature in progressive renal disease. It was hypothesized that impaired angiogenesis might occur in the diseased kidney and could contribute to renal scarring. Progressive renal disease was induced in rats by 5/6 renal ablation and those rats were compared with sham-operated control animals at multiple time points, for examination of changes in the microvasculature and the expression of angiogenic factors. An early angiogenic response was documented in remnant kidneys, with increases in the proliferation of peritubular (1 wk) and glomerular (2 wk) endothelial cells. Subsequently, however, there was a decrease in endothelial cell proliferation, which was reduced to levels below those of sham-treated animals, in conjunction with interstitial expression of the antiangiogenic factor thrombospondin-1 (TSP-1) and decreased tubular expression of the proangiogenic factor vascular endothelial growth factor (VEGF). Both the increase in TSP-1 expression and the loss of VEGF expression were correlated with capillary loss and the development of glomerulosclerosis and interstitial fibrosis. Progressive macrophage infiltration was correlated both spatially and quantitatively with the sites of absent or diminished VEGF expression. In addition, macrophage-associated cytokines (interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha) inhibited VEGF mRNA expression and protein secretion by cultured tubular epithelial cells of the medullary thick ascending limb, under both normoxic and hypoxic conditions. Impaired angiogenesis characterizes the remnant kidney model and is correlated with progression. The impaired angiogenesis may be mediated by alterations in the renal expression of TSP-1 and VEGF, with the latter being regulated by macrophage-associated cytokines.     

肝细胞生长因子负性调控细胞转分化在肾间质纤维化中的作用

目的 研究肝细胞生长因子(HGF)对单侧输尿管梗阻(UUO)大鼠肾间质纤维化的保护作用及其可能机制&#65377;方法 大鼠随机分为UUO组&#65380;HGF治疗组和假手术组&#65377;用实时荧光定量RT-PCR&#65380;Western杂交和免疫组化检测术后大鼠肾组织结缔组织生长因子(CTGF)和骨形成蛋白7(BMP7)表达量&#65377;免疫组化检测大鼠肾组织TGF-β1&#65380;FN及α-SMA表达&#65377;结果 与假手术组相比,UUO组及HGF治疗组CTGF mRNA&#65380;TGF-β1&#65380;α-SMA&#65380;FN&#65380;CTGF蛋白表达均增高,且UUO组明显高于治疗组;UUO组及HGF治疗组BMP7 mRNA和蛋白表达均减少,且UUO组显著低于治疗组&#65377;结论 HGF能减轻肾间质纤维化,负性调控肾小管上皮细胞-肌成纤维细胞转分化,调节CTGF及BMP7表达可能是其作用途径&#65377;     

坎地沙坦对单侧输尿管梗阻大鼠肾间质纤维化及肾脏骨桥蛋白表达的影响

目的 观察坎地沙坦(CAN)对单侧输尿管梗阻(UUO)大鼠肾间质纤维化的影响,并观察骨桥蛋白(OPN)与肾间质纤维化的关系及CAN干预对肾脏OPN表达的影响,探讨其在纤维化中的作用机制.方法 (1)36只成年雄性SD大鼠随机分为3组,每组12只:假手术组(Sham)、UUO模型组(UUO)、坎地沙坦治疗组(CAN).UUO模型组和CAN组大鼠行左侧输尿管结扎术,Sham组只游离左侧输尿管但不结扎.CAN组于术前1 d开始用CAN治疗[10 mg/(kg·d)]灌胃.术后第7、14天分别处死大鼠,左侧肾脏组织行Masson染色,免疫组织化学方法检测肾组织中OPN的表达,逆转录-聚合酶链反应(RT-PCR)检测OPN mRNA表达水平.结果 Masson染色结果显示术后7 d和14 d UUO组大鼠肾纤维化阳性面积分别为15.2%和24.8%,CAN组为1O.1%和18.5%.CAN组与UUO组大鼠术后7 d和14 d大鼠肾纤维化阳性面积差异有统计学意义(P＜0.05).UUO模型大鼠OPN蛋白及mRNA水平均较Sham组明显升高(P＜0.01),CAN组OPN蛋白及mRNA水平较UUO组明显降低(P＜0.05),但较Sham组高(P＜0.01).结论 CAN能有效地延缓UUO大鼠肾间质纤维化的进展,其延缓肾间质纤维化作用可能与下调OPN蛋白和mRNA有关.