放射性肾病的介质和机制。

E. Cohen, S. Bonsib, E. Whitehouse, J. Hopewell, M. Robbins
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引用次数: 21

摘要

正常组织放射损伤发生在足够的照射后,因此限制了x射线治疗的治愈潜力。在肾脏中,辐射损伤导致纤维化,最终导致肾衰竭。放射性肾病的纤维化介质很少受到关注。因此,我们在使用9.8 Gy单剂量局部肾照射的猪放射肾病模型中评估了α -平滑肌肌动蛋白(alphasma)、纤维蛋白、胶原蛋白和TGFbeta1的顺序存在。在24周的研究中,肾小球和间质有进行性和显著的胶原积累。在肾小球中,照射后2周时,这与肾小球系膜α蛋白表达显著相关,4周时进一步升高,然后逐渐下降到基线水平。照射后4周肾小球纤维蛋白沉积显著,此后保持升高。在任何时间点肾小球TGFbeta1的表达都很少或没有。照射后4周,小管纤维蛋白沉积显著,但此后逐渐减少。照射后的任何时间,小管间质α蛋白表达很少或没有表达。照射后6周,小管上皮TGFbeta1表达显著达到峰值,此后呈下降趋势。早期肾小球损伤表现为系膜α蛋白表达,但不表现为TGFbeta1表达。肾小球纤维蛋白持续沉积,纤维蛋白在小管腔内沉积,提示小管纤维蛋白来源于并流出损伤的肾小球簇。我们得出结论:1)α蛋白表达是肾小球辐射损伤的早期标志,预示着瘢痕形成;Ii)纤维蛋白沉积参与肾小球和小管辐射损伤;iii) TGFbeta1不是放射性肾病的早期事件,在该模型中肾小球中也不明显,但可能与晚期小管间质纤维化有关。因此,该模型中瘢痕形成的介质根据损伤后的时间和受影响的组织室不同而不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mediators and mechanisms of radiation nephropathy.
Normal tissue radiation injury occurs after sufficient irradiation, thus limiting the curative potential of x-ray therapy. In the kidney, radiation injury results in fibrosis and, ultimately, renal failure. The mediators of fibrosis in radiation nephropathy have received scant attention. Therefore, we evaluated the sequential presence of alpha smooth muscle actin (alphasma), fibrin, collagen, and TGFbeta1 in a porcine model of radiation nephropathy using 9.8 Gy single-dose local kidney irradiation. During the 24-week study, there was progressive and significant collagen accumulation in glomeruli and in interstitium. In glomeruli, this was associated with significant mesangial alphasma expression by 2 weeks after irradiation, a further rise at 4 weeks, and then a gradual fall to baseline. Glomerular fibrin deposition was significant by 4 weeks after irradiation, and remained elevated thereafter. There was little or no glomerular TGFbeta1 expression at any time point. Tubular fibrin deposition was significant at 4 weeks after irradiation but declined thereafter. There was little or no tubulo-interstitial alphasma expression at any time after irradiation. At 6 weeks after irradiation, there was a significant peak of tubular epithelial TGFbeta1 expression that declined thereafter. The early glomerular injury is evident as mesangial alphasma expression but is not proceeded by TGFbeta1 expression. There is sustained glomerular fibrin deposition with deposition of fibrin in tubular lumens, suggesting that tubular fibrin derives and flows out from injured glomerular tufts. We conclude that i) alphasma expression is an early marker of glomerular radiation injury, presaging scarring; ii) fibrin deposition is involved in glomerular and tubular radiation injury; and iii) TGFbeta1 is not an early event in radiation nephropathy, and not apparent in glomeruli in this model, but may correlate with later tubulo-interstitial fibrosis. Thus, the mediators of scarring in this model differ according to time after injury and also according to the affected tissue compartment.
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