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目的 初步探讨白细胞介素 18(IL 18)在人类狼疮肾炎 (LN)肾组织炎症损伤中的作用。方法 应用免疫组织化学和原位杂交技术观察 6例正常肾组织和 18例LN患者肾组织IL 18的蛋白和基因表达量 ,并用酶联免疫吸附测定 (ELISA)法对该组患者尿IL 18水平进行检测。结果 正常肾组织有弱的IL 18mRNA及蛋白表达 ;LN患者肾组织IL 18mRNA及蛋白表达量均较正常肾组织显著增高 (IL 18mRNA :8 9± 3 4比 2 2± 0 6 ;IL 18蛋白 :8 8± 3 7比 1 4± 0 4 ) ,而且WHOⅣ型LN患者肾组织IL 18表达量显著高于非WHOⅣ型LN患者 (IL 18mRNA :10 8± 3 2比6 6± 1 7;IL 18蛋白 :11 2± 2 7比 5 6± 2 0 ) ;Spearman相关分析提示肾组织IL 18蛋白表达量与狼疮肾炎肾组织活动指数 (AI)、尿IL 18水平及肾组织损伤程度均呈正相关 (P均 <0 0 5 )。结论 肾内IL 18表达上调参与LN肾组织炎症损伤过程 ,尿IL 18水平可能作为衡量LN肾组织炎症活动程度的评估指标。
Objective To investigate the role of interleukin 18 (IL 18) in the inflammatory injury of human kidney lupus nephritis (LN). Methods Immunohistochemistry and in situ hybridization were used to observe the protein and gene expression of IL-18 in 6 cases of normal renal tissue and 18 cases of LN. The levels of IL-18 in urine were measured by enzyme linked immunosorbent assay (ELISA) Test. Results The expression of IL-18 mRNA and protein in normal kidney tissue was weak. The expression of IL-18 mRNA and protein in renal tissue of LN patients was significantly higher than that in normal renal tissues (IL 18 mRNA: 8 9 ± 34 vs. 22 ± 0 6; IL 18 protein: 8 8 ± 3 7 vs 14 ± 0 4), and the expression of IL 18 in kidney tissue of LN Ⅳ patients was significantly higher than that of non-WHO LN patients (IL 18 mRNA: 108 ± 32 vs. 66 ± 1 7; IL 18 Protein: 11 2 ± 2 7 vs 56 ± 2 0). Spearman correlation analysis showed that the expression of IL 18 protein in renal tissue was positively correlated with renal tissue activity index (AI), urinary IL 18 level and renal tissue injury in lupus nephritis P <0 05). Conclusion The up-regulation of IL-18 in the kidney is involved in the process of inflammatory injury in LN. The level of urinary IL-18 may be used as a measure to evaluate the degree of inflammatory activity in LN.