The Expressions And Correlation Of AT1R And HIF-1α In Glomerulus And Juxtaglomerular Apparatus Of Patients With Lupus Nephritis

ObjectiveFifty patients and eight healthy controls were selected to this study. To detect the expressions and correlation of angiotensin-receptor-1(AT1R) and hypxia-inducible factor (HIF)-l α in glomerulus and juxtaglomerular apparatus of lupus nephritis in different types, and analyze the correlations between them with SLEDAI, complements and serum creatinine in order to explore the role of the two factors in the pathogenesis of lupus nephritis (LN).MethodsHE stain and the combination of silver and masson stain methods were used to detect immune complex form and deposition in the renal tissues. By this way we can judge LN pathological types and acute or chronic lesions. The expressions of AT1R and HIF-1a in renal biopsy specimens were measured by immunohistochemical stains (SP) from50patients with LN and8healthy controls. Pathological graphic analysis system was used to do semiquantitative estimate. Levels of SLEDAI, C3, Scr were also detected. At last to analyze the relationship between the two factors with clinical data by statistical methods. The rank-sum test or the variance analysis was used for intergroup comparison and Pearson's or Spearman's analysis was used for correlation analysis.Result1.The express quantity difference of AT1R and HIF-1a in different types of LN were significantly higher than the healthy controls. Not only in glomerular but also in macula densa, extraglomerular mesangial cell and renal tubular.2. The express quantity in type I LN was higher than the healthy controls. It shown that in the early phase of LN, RAS was activated and tissues were ischemia and hypoxia.3. The highest expressions of AT1R and HIF-1a were found in typeIV LN. Not only in glomerular but also in macula densa, extraglomerular mesangial cell and renal tubular.4. In type I LN, AT1R expressed the most in renal tubular, meanwhile HIF-1a expressed the most in macula densa. In type II,Ⅲ,Ⅳand V LN, both AT1R and HIF-1a expressed the most in macula densa. In healthy controls had few expression.5. In type I LN,there was no correlation between the expression of AT1R, HIF-1a in renal tubular and macula densa, while in the types of II,Ⅲ,IV, V LN had high correlation.6. In all types of LN, the expression of AT1R and HIF-1a in glomerular and juxtaglomerular apparatus had no correlation with SLEDAI, Scr and C3.ConclusionsThis reseach indicated that the expression of ATI R and HIF-1a in glomeru-lar, juxtaglomerular apparatus and tubulars were higher than the healty controls. Along with the degree of pathological severity, the expressions of ATI R and HIF-1a were increased. Especially, the expression in type IV was higher than the others. In the same type of LN, the highest expressions of ATI R and HIF-1a were in macular densa,the fewest were in mesangial area. The expressions of AT1R and HIF-1a in type II,Ⅲ, IV and V had high correlation. It proved that RAS was activated by ischemia and hypoxia, then it caused HIF-1a express more than before.These two factors interacted with eachother, and both of them can react the severity of diseases. However they had no correlation with SLEDAI,C3,Scr. In the Ⅳ type of LN, SLEDAI and Scr were higher than others. C3was lower than others.