[1]刘广涛,关凤军,董 晨.原发性肾病综合征患儿肾组织P-gp170蛋白和mRNA表达与临床病理及预后的关系[J].医学信息,2018,31(21):61-65.[doi:10.3969/j.issn.1006-1959.2018.21.017]
 LIU Guang-tao,GUAN Feng-jun,DONG Chen.Relationship between the Expression of p-gp170 Protein and mRNA in Renal Tissue of Children with Primary Nephrotic Syndrome and Clinical Pathology and Prognosis[J].Journal of Medical Information,2018,31(21):61-65.[doi:10.3969/j.issn.1006-1959.2018.21.017]
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原发性肾病综合征患儿肾组织P-gp170蛋白和mRNA表达与临床病理及预后的关系()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年21期
页码:
61-65
栏目:
论著
出版日期:
2018-11-01

文章信息/Info

Title:
Relationship between the Expression of p-gp170 Protein and mRNA in Renal Tissue of Children with Primary Nephrotic Syndrome and Clinical Pathology and Prognosis
文章编号:
1006-1959(2018)21-0061-05
作者:
刘广涛1关凤军2董 晨2
1.常州市第一人民医院儿科,江苏 常州 213000;2.徐州医科大学附属医院儿科,江苏 徐州 221000
Author(s):
LIU Guang-tao1GUAN Feng-jun2DONG Chen2
1.Department of Pediatrics,the First People's Hospital,Changzhou 213000,Jiangsu,China;2.Department of Pediatrics,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu,China
关键词:
肾病综合征P-糖蛋白170糖皮质激素耐药儿童
Keywords:
Neph rotic syndromeP-glycoprotein 170GlucocorticoidDrug resistanceChildren
分类号:
R726.9
DOI:
10.3969/j.issn.1006-1959.2018.21.017
文献标志码:
A
摘要:
目的 观察原发性肾病综合征患儿肾组织中P-糖蛋白170的表达,分析肾组织中P-gp170表达与临床和病理的关系,探讨P-gp170表达在PNS 患儿GC耐药中的作用。方法 采用肾活检术取得96例处于不同病程的PNS患儿肾组织标本,进行常规病理学诊断和肾脏病理定量分析;应用免疫组织化学及原位杂交法分别检测PNS患儿肾组织中P-gp170蛋白及mRNA的表达,比较不同肾脏病理类型及病理积分患儿P-gp170的表达;比较未用GC与应用GC后PNS患儿肾组织P-gp170的表达。结果 ①正常肾脏即有一定量的P-gp170表达;未用GC组即高于正常对照,差异有统计学意义(P<0.05);②病理积分较高者P-gp170表达阳性量高于病理积分低者,差异有统计学意义(P<0.05);不同病理类型P-gp170的表达有差异,局灶节段硬化(FSGS)、膜性肾病(MN)和硬化性肾病(SGN)表达较高,组间比较差异无统计学意义(P>0.05),微小病变(MCD)和系膜增生型(MsPGN)者表达较低,两者比较差异无统计学意义(P>0.05);而前三者与后两者差异有统计学意义(P<0.05);③未用GC者较应用GC后的PNS患儿肾组织P-gp170表达量低,差异有统计学意义(P<0.05)。结论 P-gp170在PNS患儿肾组织的表达可能与肾病病损有关,可结合病理类型和病理损伤程度同时检测肾组织P-gp170预测不同患儿GC反应性; P-gp170的表达增高可能与PNS活动和复发有关,可作为临床预测预后的指标。
Abstract:
Objective To observe the expression of P-glycoprotein 170 in renal tissues of children with primary nephrotic syndrome, and to analyze the relationship between P-gp170 expression and clinical and pathological changes in renal tissues, and to investigate the expression of P-gp170 in GC-resistant children with PNS effect. Methods Renal tissue samples from 96 children with PNS in different stages of disease were obtained by renal biopsy. The routine pathological diagnosis and quantitative analysis of renal pathology were performed.Immunohistochemistry and in situ hybridization were used to detect the expression of P-gp170 protein and mRNA in renal tissues of children with PNS, and the expression of P-gp170 in different renal pathological types and pathological scores were compared.The expression of P-gp170 in renal tissue of children with PNS after GC and GC application was compared.Results ①There was a certain amount of P-gp170 expression in normal kidney,The GC group was significantly higher than the normal control group,the difference was statistically significant (P<0.05).②The positive expression of P-gp170 was higher than the pathological score,the difference was statistically significant (P<0.05).The expression of P-gp170 was different in different pathological types. The expressions of focal segmental sclerosis (FSGS), membranous nephropathy (MN) and sclerosing nephropathy (SGN) were higher. There was no significant difference between the two groups (P>0.05). The expressions of microscopic lesions (MCD) and mesangial proliferative (MsPGN) were lower,the difference was not statistically significant (P>0.05). The difference between the first three and the latter two was statistically significant (P<0.05).③The expression of P-gp170 in renal tissue of children with NS after GC was lower than that of patients with GC, the difference was statistically significant (P<0.05). Conclusion The expression of P-gp170 in renal tissue of PNS children may be related to nephropathy. Renal P-gp170 can be combined with pathological type and degree of pathological injury to predict GC reactivity in different children. The increased expression of P-gp170 may be related to the activity and recurrence of PNS, and can be used as a predictor of prognosis.

参考文献/References:

[1]Hodson EM,Knight JF,Willis NS.Corticosteroid therapy for nephrotic syndrome in children [J].The Cochrane Library,2005,25(1):CD001533. [2]关凤军,易著文,何小解,等.肾病综合征患儿肾组织P-糖蛋白170表达的研究[J].中国实用儿科杂志,2007,22(10):780-782. [3]吴小川,易著文,何小解,等.小儿紫癜性肾炎肾脏病理定量分析[J].湖南医科大学学报,2000,25(4):403-405. [4]Sadowski CE,Lovric S,Ashraf S,et al.A Single-Gene Cause in 29.5% of Cases of Steroid-Resistant Nephrotic Syndrome[J].J Am Soc Nephrol,2015,26(6):1279-1289. [5]Che R,Zhang A.Mechanisms of glucocorticoid resistance in idiopathic nephrotic syndrome[J]. Kidney Blood Press Res,2013,37(4-5):360-378. [6]Türkmen M,Torun Bayram M,Soylu A,et al.The relationship between renal P-glycoprotein expression and response to steroid therapy in childhood nephrotic syndrome[J].Turk J Pediatr, 2013,55(3):260-265. [7]Tanaka S,Masuda M,Nakajima K,et al.P-glycoprotein function in peripheral T lymphocyte subsets of myasthenia gravis patients: clinical implications and influence of glucocorticoid administration[J].Int Immunopharmacol,2009,9(3):284-290. [8]Brozek J,Bryl E,Ploszyńska A,et al.P-glycoprotein activity predicts outcome in childhood acute lymphoblastic leukemia[J].J Pediatr Hematol Oncol,2009,31(7):493-499. [9]Wu B,Mao J,Shen H,et al.Triple immunosuppressive therapy in steroid-resistant nephrotic syndrome children withtacrolimus resistance or tacrolimus sensitivity but frequently relapsing [J].Nephrology (Carlton),2015,20(1):18-24. [10]Fujinaga S,Shimizu T.Chronic cyclosperine-induced nephrotoxicity in children with steroid-resistant nephrotic syndrome[J].Pediatr Nephrol,2013,28(10):2065-2066.

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更新日期/Last Update: 2018-11-20