| Objective:(1)To research Renal vascular endothelial growth factor (VEGF) and its receptor (FLK-1) expression in chronic primary glomerulonephritis(CPGN). To analysis the relationship of VEGF, FLK-1 with renal pathology ,renal function and urinary protein.(2)At the same time,we treat the CPGN patient with Chinese Herbs of huoxuequshi decoction combined with general medicine(for example prednisolone etc,), and then observeing the serum VEGF levels and serum creatinine (Scr), creatinine clearance (Ccr) and urine protein / urine creatinine ratio before and after the treatment, Finally,we discuss the molecular biological mechanisms of the huoxuequshi decoction .Methord:(1)35 patients with chronic primary glomerulonephritis were enrolled, all of them were confirmed by kidney biopsy, while we detect the levels of VEGF and FLK-1 in the renal tissue by the method of real-time quantitative reverse transcription polymerase chain technique (RT-PCR) , and establishing the control group of 5 cases with adjacent normal renal tissue (2)40 patients with being diagnosised CPGN were divided into two groups by random, one group of 20 cases were routinely treated with general medicine(for example, prednisolone etc,) , the other group were added with huoxuequshi decoction. All of them were treated for two months. Before and after the treatment we tested serum VEGF levels by the method of enzyme-linked immunosorbent assay (ELISA),at the same time Scr, Ccr and urine protein / urine creatinine ratio changes was also being tested too. Meanwhile, 10 cases of normal peripheral blood is detected as a control comparison。Result :(1)The relative expression levels of VEGF and FLK-1 in renal tissues of patients CPGN were 0.125±0.071and 0.073±0.024, in adjacent normal renal tissue levels were as 0.063±0.013 and 0.038±0.015, the expression levels of VEGF mRNA and FLK-1 mRNA in the CPGN group were significantly higher than in a healthy controls (P <0.05).(2)VEGF, FLK-1 and renal pathological changes in mesangial proliferation, segmental lesions and interstitial inflammatory cells showed a significant positive correlation (r values were 0.5221 and 0.4181; 0.5258 and 0.6272; 0.8453 and 0.6981; P<0.05 ), Where interstitial infiltration of inflammatory cells with the highest correlation degree. (3) the serum VEGF expression is different in CPGN with different pathological types. The expression of serum VEGF were higher than the normal control group in minimal change glomerulonephritis (MCNS)group,Mesangial proliferative glomerulo- nephritis(MsPGN)group,Focal segmental glomerulonephritis(FSGS) group and membranous nephropathy (MN) group (P <0.05), and serum creatinine and urinary protein excretion showed a significant positive correlation (P <0.05), but the expression serum VEGF levels in Sclerosising glomerulonephritis (SGN) group is lower than normal control group, serum creatinine and urinary protein and no significant correlation (P> 0.05) (4)The levels of serum VEGF and urine protein / urine creatinine ratio were significantly decreased after the huoxuequshi decoction therapy in chronic primary glomerulonephritis (P <0.01), the difference had remarkable significance.Conclusion:(1) The expression levels of VEGF and its receptor FLK-1 in renal tissue of CPGN patients was higher than normal, suggesting that VEGF and FLK-1 can be used as indicators of renal disease detection.(2) The expression levels of VEGF and its receptor FLK-1 may reflect renal pathology of mesangial proliferation and interstitial inflammatory cell infiltration level. (3) The expression of VEGF in MCNS, MSPGN, FSGS and MN may be one of the factors leading to renal pathological deterioration .However,at the end stage of renal disease when appearing diffusing glomerulosclerosis, the expression of VEGF decreased.(4)Huoxuequshi decoction could restrain the secretion and expression of VEGF, it slowed down urine protein and reduce the renal inflammatory response. This might be one of mechanism of treating chronic primary glomerulonephritis. |
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