目的 通过膜性肾病经典的动物模型被动Heymann肾炎(PHN),探讨足细胞自噬在膜性肾病病变过程中的作用,以及自噬激活可能的细胞内机制.方法 SPF级健康雄性SD大鼠按随机数字表法分为5组即对照组、PHN 2 d组、PHN 4 d组、PHN 7 d组、PHN 21 d组,建立大鼠PHN模型.采用透射电镜观察足细胞形态和自噬泡,Weibel-Gomez点计数法计数单个肾小球足细胞数量,免疫组织化学染色检测肾小球内膜攻击复合物C5b-9的沉积与半胱氨酸天冬氨酸蛋白酶(caspase)-3的表达,原位缺口末端标记(TUNEL)法检测肾小球内细胞凋亡,Western印迹法检测肾小球自噬相关蛋白微管相关蛋白1轻链3(microtubule-associated protein 1 light chain 3,LC3)、葡萄糖调节蛋白(GRP)78、磷酸化蛋白激酶R样内质网激酶(phosphorylated protein kinase R-like ER kinase,p-PERK)、磷酸化c-Jun氨基末端激酶(phosphorylated c-jun aminoterminal kinase,p-JNK)、活化转录因子6α(activating transcription factor 6α,ATF6α)的表达.结果 (1)造模后第4天起即可在肾小球内观察到C5b-9沿基底膜呈线状沉积.同时,透射电镜下可见上皮下少许颗粒状电子致密物沉积及足突融合,病变随时间呈加重趋势,至第21天可见典型膜性肾病改变.此外,尿蛋白定量结果显示,造模第3天起尿蛋白量即有明显升高,至第21天时可高达(50.6±6.0) mg/24 h.(2)造模后第21天单位肾小球足细胞绝对数目较对照组显著下降(P<0.05).(3) caspase-3表达和TUNEL染色结果一致显示,造模后第21天肾小球内可检出凋亡的足细胞.(4)透射电镜和自噬标志LC3Ⅱ的检测结果均显示,造模后第7天和第21天足细胞的自噬水平均显著升高,但第21天LC3Ⅱ的表达较第7天有所回落.(5)造模后第2天即可检出GRP78高表达,至第7天时显著升高,而病变后期(第21天)又有所回落;同时,非折叠蛋白反应传感器下游的3条信号通路(ATF6α、p-PERK及p-JNK)也在造模早期活化,后期(第21天)同样有所回落.结论 膜性肾病
Objective To investigate the role of autophagy in podocyte damage,and the intracellular mechanism of autophagy activation through passive Heymann nephritis (PHN) animal model.Methods Male Sprague-Dawley rats (n=40) were studied on day 0,2,4,7,and 21 after induction of PHN by injection of anti-Fx1A.Podocyte morphology and autophagosomes were observed by transmission electron microscopy.Podocyte numerical density was estimated by Weibel-Gomez =method.Cell apoptosis was detected by TUNEL assay and caspase-3 immunohistochemical staining.Expressions of autophagy markers and endoplasmic reticulum stress (ERS)-associated proteins were analyzed by Western blotting.Results (1) In PHN rats,immunohistochemical staining showed that C5b-9 deposited along glomerular basement membrane on day 4 to day 21.Small subepithelial electron -dense deposits and a part of foot process fusion were detected in the glomerulus of PHN rats on day 4 by transmission electron microscope,and podocyte damage was aggravat