目的 应用抗体芯片技术检测慢性肾脏病(CKD)患者尿液中细胞因子的水平,并探讨其临床意义。方法 研究对象共10例,7例为CKD患者,全部符合K/DOQI指南中CKD的诊断标准,并且有肾脏病理诊断。依据GFR水平以及CKD分期,将7例患者分为两组:Ⅰ组:GFR≥80ml·min^-1·(1.73m^2)^-1(CKD1~2期)共4例;Ⅱ组:GFR≤40ml·min^-1·(1.73m^-2)^-4(CKD3~5期)共3例。另选取3例性别、年龄相匹配的健康人作为正常对照。应用Raybiotech人类细胞因子抗体芯片,同时检测各组尿液中20种细胞因子水平的变化。结果 与正常对照组相比,CKD患者共有15种因子的水平发生了显著变化。单核细胞趋化蛋白(MCP)-1、RENTES、金属蛋白酶组织抑制物(TIMP)-1、肿瘤坏死因子(TNF)-α、血管内皮生长因子(VEGF)、E-选择素(seletin)、Fas、细胞间黏附分子(ICAM)-1、白细胞介素(IL)-2、基质金属蛋白酶(MMP)-2、转化生长因子(TGF)-β和血小板源生长因子(PDGF)-BB的水平同正常对照组相比升高了2~5倍,其中尿MCP-1,RANTES,TIMP-1,TNF-α和VEGF的水平随着GFR的下降而进一步升高。VCAM-1和PDGF-BB的水平同正常对照组相比有所下降。在芯片所包含的20种细胞因子中,MMP-9的水平变化尤其显著,同正常对照组相比,CKDI组是正常对照组的492.8倍,CKDⅡ组是正常对照组的198.7倍。结论 首次应用抗体芯片技术,证实CKD患者尿液中细胞因子表达水平同正常对照组有明显差异,并且与疾病所处阶段有一定的关系。
Objective To apply a novel proteomic technology to analyze urinary cytokine profiles in patients with CKD. Methods Ten subjects including 7 CKD patients and 3 normal controls were enrolled in this study. Differential excretion of urinary cytokines was determined by human cytokines antibody array (Raybiotech Norcross GA). As compared to controls, a two-fold change in spot intensity was considered significant. Results A total of 15 cytokines varied significantly in urinary samples from patients with CKD, comparing with controls. It was shown that MCP-1, R-ANTES, TIMP- 1,TNF-α, VEGF, E-selectin, Fas, ICAM-1, IL-2, MMP-2, TGF-β increased by two to five folds in CKD patients with normal renal function, while the excretion of MCP-1, RANTES, TIMP-1, TNF-α and VEGF was further increased with the declining of renal function. A decreasing excretion of urinary VCAM-1 and PDGF was found in patients with renal failure. Impressively, the urinary MMP-9 excretion was 492 folds increase in CKD patients with normal renal function and 198 folds increase in renal failure patients as compared to normal controls. Conclusion A significant change of urinary cytokine profiles in patients with CKD is firstly demonstrated as compared to normal controls by using a novel antibody array technology, which may provide important information regarding to the role of cytokines in the progression of CKD.