目的 探讨B淋巴细胞刺激因子(BlyS)及其Blys受体3(BR3)在狼疮性肾炎(LN)中的作用.方法 ELISA法检测系统性红斑狼疮(SLE)患者及正常健康体检者血清BlyS、肿瘤坏死因子-α(TNF-α)和白介素-1(IL-1)的表达水平,免疫组化法检测肾活检确诊为LN的患者及正常对照者肾组织中BlyS及其BR3的表达水平.结果 SLE患者血清Blys、TNF-α以及IL-1的水平显著高于正常对照者(P<0.01);正常对照者的肾小管上皮细胞可中等强度表达BlyS,而LN患者除了肾小管上皮细胞外,肾小管间质浸润的炎性细胞也可表达Blys;正常对照肾组织内无BR3的表达,而LN患者肾组织内有极少BR3的表达,仅见于炎性细胞聚集区;LN患者肾内BlyS的表达水平显著高于正常对照者(P<0.01),且Ⅳ型与Ⅴ型LN肾内BlyS的表达水平均明显高于Ⅲ型LN(P<0.05),而Ⅳ型与Ⅴ型LN间BlyS的表达水平虽差异无统计学意义,但有升高趋势.结论 SLE患者血清BlyS的水平升高,LN患者肾内BlyS的表达水平升高,肾内BR3受体有极少量的表达,提示BlyS及其BR3的变化与LN的病理变化有关.%Objective To explore the role of B lymphocyte stimulator ( BlyS ) and BR3 in lupus nephritis( LN ). Methods The serum concentrations of Blys, TNF-a and IL-1 were detected by ELISA in SLE patients and normal controls, and intrarenal expressions of BlyS and BR3 were detected by immunohistochemistry in renal tissues of LN patients and normal-appearing renal tissues. Results The serum concentrations of BlyS,TNF-a and IL-1 in SLE patients were obviously higher than those in normal controls( P <0. 01 ); Intermediate-intensity staining of BlyS was detected in renal tubules in normal-appearing renal tissues, however, both renal tubules and infiltrating cells had the ability to produce BlyS in LN patients; All of the normal-appearing renal tissues were negative for BR3, and it was restricted to a small population of infiltrating cells in renal tissues of LN patients; The intrarenal production of BlyS in LN patients was obviously higher than that in normal-appearing renal tissues( P < 0. 01 ), and the expression levels of BlyS in LN IV and V were higher than those in LN IV( P < 0. 05 ), although there was no statistically significant difference between LN IV and V ,we could see a rise trend in the expression levels of BlyS. Conclusion The serum BlyS level is significantly elevated in SLE patients. Intrarenal expression of BlyS is elevated in LN patients, and there is no significant intrarenal expression of BR3. There may exsit some association between the change of BlyS and BR3 and the diversity of the pathology category of LN.
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