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目的肥大细胞具有高度异质性,不同亚型肥大细胞具有不同的表型和功能特点。目前对于肾组织肥大细胞的表型仍缺乏全面的分析,少数文献间的结果也差异很大。文中以较大的样本量,通过对不同病理时期糖尿病肾病(diabeticnephyopathy,DN)患者肾组织肥大细胞的分型研究,以阐明DN患者肾组织肥大细胞的表型特点。方法选取不同病理时期的DN患者共80例,分为DN早期组(19例)、DN中期组(32例)和DN晚期组(29例);同时选取正常供肾10例作为正常对照(对照组)。利用抗肥大细胞类胰蛋白酶抗体和抗肥大细胞糜蛋白酶抗体,分别对肾穿刺组织标本连续切片进行免疫组化染色分析,根据连续切片中的肥大细胞表达类胰蛋白酶和糜蛋白酶的情况,对DN患者肾组织肥大细胞进行分型分析。结果①双连续切片的分析发现,正常对照和DN患者肾组织中的绝大多数肥大细胞表现为类胰蛋白酶和糜蛋白染色双阳性,仅有少数肥大细胞在双连续切片染色分析时表现为类胰蛋白酶或糜蛋白酶单阳性。②“双夹心”连续切片分析法显示,在我们所分析过的DN患者肾组织肥大细胞中,未发现真正的类胰蛋白酶或糜蛋白酶单阳性肥大细胞,双连续切片法中发现的类胰蛋白酶或糜蛋白酶染色单阳性系由切面的差异所致。③比较以类胰蛋白酶和糜蛋白酶为标记分子得到的DN患者肾组织肥大细胞记数结果显示,通过2种标记分子检测到的肥大细胞数无统计学意义。结论 MCTC亚型是正常个体和DN患者肾组织肥大细胞的基本亚型;DN患者肾组织中即使存在MCT和MCC2种肥大细胞亚型,其数量也不会太多。
The purpose of mast cells with high heterogeneity, different subtypes of mast cells have different phenotype and functional characteristics. At present, there is a lack of comprehensive analysis on the phenotype of renal tissue mast cells, and the results among a few literatures vary greatly. In a large sample size, we investigated the phenotypic characteristics of renal tissue mast cells in patients with DN by analyzing the classification of renal tissue mast cells in patients with diabetic nephropathy (DN) at different pathological stages. Methods A total of 80 DN patients with different pathological stages were selected and divided into three groups: DN early stage group (19 cases), DN intermediate stage group (32 cases) and DN advanced stage group (29 cases). Ten normal kidneys were selected as normal control group group). Using anti-mast cell tryptase antibody and anti-mast cell chymotrypsin antibody, immunohistochemical staining was performed on the serial sections of the renal puncture tissue samples. According to the expression of tryptase and chymotrypsin in the mast cells in serial sections, Patients with renal tissue mast cells for typing analysis. Results ① Double serial sections analysis found that the majority of mast cells in normal control and DN patients showed double positive staining of tryptase and minced protein, and only a few of mast cells appeared in the double serial section staining analysis Trypsin or chymotrypsin single positive. ② “double sandwich” serial section analysis showed that in our analysis of DN patients with renal tissue mast cells, did not find true tryptase or chymotrypsin single positive mast cells found in the double serial sections of the class Trypsin or chymotrypsin staining of single positive line due to the differences caused by the section. ③ Comparison of trypsin and chymotrypsin markers for DN patients with renal tissue mast cell count results show that the two markers detected by the number of mast cells was not statistically significant. Conclusion MCTC subtype is the basic subtype of renal tissue mast cells in normal individuals and DN patients. Even if there are two kinds of MCT and MCC mast cell subtypes in the kidney of DN patients, the number is not too much.