Expression And Significance Of Intergrin Alpha(v)beta(3) In The Renal Tissue Of Patiens With IgA Nephropathy

Objective: To examine the expression of intergrin alphavbeta3(ανβ3),connective tissue growth factor (CTGF) fibronectin(Fn) in the renal tissue of IgA nephropathy patiens with different degree of pathological change ,and the relationship between the express and clinicopathological changes were analyzed to explore the significance ofανβ3 in the clinicopathological process of IgA nephropathyMethods: IgA nephropathy 53 cases( male 29 cases,female 24 cases,age 35±11 year)which were definited through clinical and renal biopsy light microscope as well as immuneofluorescence by nephros medical department of Hebei medical University the second hospital, exclude Henoch Schonlein Purpura nephritis,nephritis associated with hepatitis B,lupus nephritis,hepatic sclerised glomerulosclerosis and so on . IgA nephropathy renal tissue were devided into gradeⅠ-Ⅳby katafuchi standard .immunoperoxidase staining was performed to detected the expression ofανβ3,fibronectin(Fn) and Connective tissue growth factor (CTGF) in the kidney of patiens with IgA nephropathy,then calculate respectively the positive area ratio by pathologic picture analysis. Collect the clinical index which include sex,age,24 hour Urine protein quantitation,serum complement C3,serum IgA,albumin,blood fat,bear water 8 hour urine osmotic pressure,creatinine clearance rate,blood pressure,course of disease and so on; the relationship between the express thatανβ3,Fn and CTGF in the renal tissue and clinicopathological changes were analyzed.Result: 1.ανβ3 was mainly located in the glomerular capillary endothelial,proximal and distal tubular epithelial cell in control group.In IgA nephropathy kidney tissuesανβ3 was mainly located in the glomerular capillary endothelial,partly expressed in mesangial cells,epithelial cell,glomerular crescent,proximal and distal tubular epithelial cell. With the advancement of the disease, theανβ3 expression was gradually increased in gradeⅠ-Ⅲ, Among all the groups ,the expression ofανβ3 was the strongest in gradeⅢ,but in gradeⅣthe expression was decrease than gradeⅢ, p<0.05. the positive area ratio of integrinανβ3 in glomerulus is(10.23±7.53)% in control group,and glomerular sclerosis ratio is 0.7%. In gradeⅠ～Ⅳ, the express ofανβ3 in the glomerulus in IgA nephropathy were[(16.18±0.98),(19.58±0.99), (28.35±1.99), (17.72±2.17) ]%,respectively; glomerular sclerosis ratio respectively were 9%,18.9%,34.8%,54.6%.theανβ3 express In gradeⅡ～Ⅳof IgA nephropathy was all increased than control group,p均<0.05; the expression ofανβ3 in gradeⅢwas higher than gradeⅠ,Ⅱ,Ⅳ,and gradeⅣwas decreased than gradeⅢin IgA nephropathy, P<0.05. The expression ofανβ3 which were in renal interstitium in gradeⅠ-Ⅲof IgA nephropathy hadn,t statistical significance compared with control group, P>0.05;but the expression ofανβ3 in gradeⅣwas obviously decreased than other group, P<0.05 2. Fn was mainly located in Glomerular mesangium interstitial substance,glomerular basement membrane, renal interstitium or small vessels wall express little. In control group location of the Fn expression were coincident,but the degree were obviously weaker.with the mesangial region expand in IgA nephropathy, scope and intensity which the Fn expressed was gradually increased, and were especially obviouse in glomcrular Segmented sclerosis location,but lower in superseded glomcrulus. Fn average integral were significantly higher than control group in mesenterium region and renal interstitium P<0.05. Positive correlations were found between the degree of Fn in glomerular mesangium and glomerular lesion grading or tubulointerstitial lesion grading( r=0.724,P<0.01;r=0.512,P<0.01). 16 patient had Fn distributed only in mesangium, and 37 had Fn along the capillary walls as well as mesangium. 3. the positive area ratio of integrinανβ3 in glomerulus:ανβ3 in immunofluorescence FRA masculine group express higher than negative group,the quantity respectively was [(26.38±11.06)(,18.91±7.53)] %,P<0.05,but glomerular filtration rate decrease than negative group,P<0.05.ανβ3 in the group that IgA and Fn deposited along the capillary walls as well as mesangium was higher than only in mesangium,respectively[(24.63±11.49vs18.57±13.48)% ,( 27.41±8.05vs17.82±6.54)%],P均<0.05; but glomerular filtration rate decrease than the second group. the positive area ratio ofανβ3 in glomerulus had no statistical significance with the location that IgM,IgG and C3c deposited.4.The expression of CTGF was mainly detected in tubular epithelial cells and glomcrular capsule wall in control group renal tissue;in IgA nephropathy was mainly detected in tubular epithelial cells(atrophy and degenerative epithelial cells were most manifest ),fibroblast,Glomerular mesangium .The expression of CTGF in severe tubulointerstitial lesions was much more than those in minimal change.The expression intensity of CTGF was positive correlated to degree of tubulointerstitial firosis .The positive area ratio ofανβ3 was positive correlated with the expression intensity of Fn in glomerulus and CTGF in renal interstitium(r=0.85,P<0.01;r=0.72,P<0.05),as well as glomerular sclerosis(r=0.64,P <0.05),but had no statistical significance with the expression intensity of CTGF in glomerulus.the positive area ratio ofανβ3 in glomerulus was positive correlated with the quantity of serum IgA ; positive correlated with 24 hour Urine protein quantitation in gradeⅠ-Ⅲof IgA nephropathy(r=0.635, P<0.01);had no statistical significance with sex,age,serum complement C3,albumin,blood fat,bear water 8 hour urine osmotic pressure,creatinine clearance rate,blood pressure,course of disease . the expression intensity of Fn and CTGF was positive correlated with 24 hour Urine protein quantitation and creatinine clearance rate(r=0.834, P <0.01;r=0.728, P <0.01),had no statistical significance with sex,age,serum complement C3,serum IgA,albumin,blood fat,bear water 8 hour urine osmotic pressure,blood pressure,course of disease .Conclusion:1. Intergrin alph(av)bet(a3) have a abnormal expression in IgA nephropathy.2.ανβ3 was correlated with the abnormal deposition of extracellular matrix and glomerular sclerosis,as well as IgA deposited location and 24 hour Urine protein quantitation ,its expression which increase in renal tissue in IgA nephropathy may show unfavourable prognosis.3. CTGF may have a intergrin way to promote extracellular matrix deposition.