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目的:研究Smad7和Foxp3在慢性移植肾肾病(CAN)中的作用以及两指标在该疾病中的潜在联系。方法:应用ELISA法和原位杂交技术分别检测32例不同病理分级CAN(其中CANⅠ级10例,Ⅱ级9例,Ⅲ级13例)患者外周血中及活检标本当中的Smad7和Foxp3水平,另取9例移植后肾功能正常志愿患者的活检标本和外周血标本做为对照。结果:CAN各级的Smad7和Foxp3表达水平无论是外周还是活检标本当中皆明显低于对照组的表达水平(P<0.05),而CANⅠ级与CANⅡ级差异无统计学意义(P>0.05),CANⅠ级和CANⅡ级对比CANⅢ级的表达水平差异有统计学意义S(P<0.05),Smad7和Foxp3的表达有明显联系(P<0.05),而有3例标本两者的表达差异较大。结论:移植肾活检穿刺能客观的反映CAN的病理变化,而外周血当中的Smad7和Foxp3水平基本能够反映CAN的发展程度,是检测CAN的一个不错的无创指标,Smad7和Foxp3对慢性移植肾肾病的发生发展起重要作用,而Smad7可能通过某种机制调控Foxp3的表达。
AIM: To investigate the role of Smad7 and Foxp3 in chronic allograft nephropathy (CAN) and the potential link between these two indices in this disease. Methods: The levels of Smad7 and Foxp3 in peripheral blood and biopsy specimens from 32 patients with CAN (10 cases of CAN Ⅰ, 9 cases of Ⅱ, 13 cases of Ⅲ) were detected by ELISA and in situ hybridization respectively. Take 9 cases of normal renal function after transplantation in patients with biopsy specimens and peripheral blood samples as a control. Results: The expression levels of Smad7 and Foxp3 at all levels in CAN were significantly lower than those in control group (P <0.05), but there was no significant difference between CAN Ⅰ level and CAN Ⅱ level (P> 0.05) There was a significant difference in CAN Ⅲ level between CAN Ⅰ and CAN Ⅱ (P <0.05), but there was a significant correlation between Smad7 and Foxp3 expression (P <0.05). Conclusion: Transplantation renal biopsy can objectively reflect the pathological changes of CAN. However, the level of Smad7 and Foxp3 in peripheral blood can basically reflect the development of CAN, which is a good noninvasive index for detecting CAN. Smad7 and Foxp3 can inhibit the development of chronic allograft nephropathy Of the occurrence and development of an important role, and Smad7 may regulate Foxp3 expression through some mechanism.