NLRP3炎症小体表达与狼疮性肾炎临床病理特征及远期预后的关系.docVIP

NLRP3炎症小体表达与狼疮性肾炎临床病理特征及远期预后的关系

摘要：目的探讨NLRP3炎症小体表达水平与狼疮性肾炎（LN）临床病理特征及远期预后的关系。方法选择2015年5月-2016年12月期间在我院首次诊断为LN的患者作为LN组，同期因外伤而切除肾脏组织的患者作为对照A组，体检的健康志愿者作为对照B组。检测肾脏组织中NLRP3、ASC、Cleavedcaspase-1的表达及血清中IL-1β、IL-18的含量，分析NLRP3表达与临床病理特征及远期肾脏生存的关系。结果LN组患者肾脏组织中NLRP3、ASC、Caspase-1的相对表达水平及阳性表达率均高于对照A组，血清中IL-1β和IL-18的含量均高于对照B组且分别与NLRP3、ASC和Cleavedcaspase-1呈正相关；与LN组肾脏组织NLRP3阴性患者比较，NLRP3阳性患者的24小时尿蛋白定量、尿沉渣红细胞数、BUN、Scr、SLE-DAI评分及累积ESRD发生率均增加，eGFR降低。结论LN肾脏中NLRP3炎症小体表达增加且与临床病理恶化、ESRD增多有关。

关键词：狼疮性肾炎；NLRP3炎症小体；临床病理特征；终末期肾病

TherelationshipbetweentheexpressionofNLRP3inflammasomeandtheclinicopathologicalcharacteristics,long-termprognosisoflupusnephritis

Abstract:ObjectiveToexploretherelationshipbetweentheexpressionofNLRP3inflammasomeandtheclinicopathologicalcharacteristics,long-termprognosisoflupusnephritis(LN).MethodspatientsdiagnosedasLNforthefirsttimeinourhospitalfromMay2015toDecember2016wereselectedasLNgroup,patientswithkidneytissueresectionduetotraumaatthesametimeascontrolgroupA,andhealthyvolunteersascontrolgroupB.TheexpressionofNLRP3,ASC,Cleavedcaspase-1inrenaltissueandthecontentofIL-1β,IL-18inserumweremeasured.TherelationshipbetweentheexpressionofNLRP3andclinicopathologicalcharacteristicsandlong-termrenalsurvivalwasanalyzed.ResultstherelativeexpressionlevelofNLRP3,ASCandcaspase-1andthepositiveexpressionrateofNLRP3inrenaltissueofLNgroupwerehigherthanthoseofcontrolgroupA,thecontentsofIL-1βandIL-18inserumwerehigherthanthoseofcontrolgroupB,andNLRP3,ASCandCleavedcaspase-1werepositivelycorrelatedwithIL-1βandIL-18;comparedwithNLRP3negativepatientsinrenaltissueofLNgroup,24-hoururineproteinquantity,urinesedimentredcellcount,BUN,Scr,theSLE-DAIscoreandcumulativeincidenceofEndstagerenaldisease(ESRD)significantlyincreased,eGFRdecreased.Conclusiontheincreasedexpression