jofinЖурнал инфектологииJournal Infectology2072-6732IPO “АIDSSPbR"10.22625/2072-6732-2012-4-1-29-35jofin-82Research ArticleОригинальные исследованияOriginal ResearchРОЛЬ CHLAMYDIA TRACHOMATIS ПОЧЕЧНОЙ ТКАНИ В ПАТОГЕНЕЗЕ IGA-НЕФРОПАТИИ С УЧЕТОМ ВОЗРАСТА БОЛЬНОГОThe role of Chlamydia Trachomatis in renal tissue in the pathogenesis IGA-nephropathy related to ageРакитянскаяИ. А.RakityanskayaI. A.

научный консультант, клинический иммунолог Больницы Святого Великомученика Георгия, д.м.н., профессор; тел. +7-921-593-55-17

tat-akyla@inbox.ruРябоваТ. С.RyabovaT. S.

заведующая 2-м терапевтическим отделением Больницы Святого Великомученика Георгия, к.м.н.; тел. +7-921-405-98-85

tita74@mail.ruБольница Святого Великомученика Георгия, Санкт-ПетербургРоссияHospital of Holy Martyr George, Saint-PetersburgRussian Federation201209092014412935Copyright © Ракитянская И.А., Рябова Т.С., 20142014Ракитянская И.А., Рябова Т.С.Rakityanskaya I.A., Ryabova T.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.niidi.ru/jofin/article/view/82

IgA-нефропатия является наиболее часто встречающейся формой первичного гломерулонефрита в мире и поэтому сегодня активно изучаются механизмы развития этого заболевания. В нашем исследовании проведен анализ биопсии почек у 117 больных IgA-нефропатией на присутствие антигена Chlamydia trachomatis до и после 60 лет. В работе показано, что присутствие C. trachomatis в гломерулярной зоне влияет на выраженность сегментарного склероза (р<0,05), а присутствие ее в интерстиции – на размер клубочка (р<0,02) и выраженность дистрофии эпителия канальцев (р<0,02) независимо от возраста больного. Также выявлено влияние этого антигена на выраженность местного иммунного ответа почечной ткани. У больных до 60 лет C. trachomatis в клубочке влияет на количество клеток фенотипа CD25 (p=0,04) и CD19/κ (p=0,034) в составе гломерулярного инфильтрата; наличие антигена в интерстиции влияет на экспрессию CD95(APO-1/Fas) (p=0,038) мононуклеарами инфильтрата и формирование депозитов С5b-C9 (p=0,042) в интерстициальном пространстве. У больных старше 60 лет присутствие C. trachomatis в гломерулярной зоне влияет на экспрессию TNF-α (p=0,039) в клубочке; наличие C. trachomatis-антигена в интерстиции оказывает влияние на количество клеток CD71 (p=0,025) в составе интерстициального инфильтрата. На основании полученных результатов нами сделан вывод, что присутствие антигена Chlamydia trachomatis оказывает влияние на развитие и течение заболевания и является этиологическим фактором у больных IgA-нефропатией независимо от возраста.

IgA-nephropathy is the most common form of primary glomerulonephritis in the world and therefore the mechanisms of this isease are actively explored. In our study, an analysis of renal biopsy issue from 117 patients IgA-nephropathy in the presence of Chlamydia trachomatis antigen related to age (before and after 60 years). It was shown that the presence of C. trachomatis in the glomerular zone influence on the severity of segmental sclerosis (p <0.05), and its presence in the interstitium affect on the size of the glomeruli (p <0.02) and severity of degeneration of epithelial tubules (p <0.02) regardless of patient age. It was shown the effect of C. trachomatis on the expression of local immune response of kidney tissue. In patients under 60 years: C. trachomatis in the glomeruli affects the number of cells of the phenotype CD25 (p = 0,04) and CD19 / κ (p = 0,034) in the glomerular infiltration and the presence of antigen in the interstitium affect the expression of CD95 (APO-1/Fas) (p = 0,038) by mononuclear cells infiltration and formation of deposits S5b-C9 (p = 0,042) in the interstitial space. In patients older than 60 years of presence C. trachomatis in the glomerular zone impacts on the expression of TNF-α (p = 0,039) in the glomeruli, the presence of antigen in interstitium affect the number of cells CD71 (p = 0,025) in the interstitial infiltrate. Based on these results, we concluded that the presence of Chlamydia trachomatis antigen has an impact on the development and course of the disease and is the etiologic agent in patients with IgA-nephropathy, regardless of age.

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The authors declare that there are no conflicts of interest present.