EKSPRESIJA NEURALNOG ĆELIJSKOG ADHEZIONOG MOLEKULA U INTERSTICIJUMU BUBREGA SA RAZLIČITIM STEPENOM FIBROZE

Ana Mioljević; Isidora Filipović; Gorana Nikolić; Aleksandar Janković; Nikola  Bogosavljević; Petar Đurić; Novica Boričić; Maja Životić

doi:10.5937/smclk4-46516

Ana Mioljević Medicinski fakultet, Univerzitet u Beogradu
Isidora Filipović Univerzitet u Beogradu, Medicinski fakultet, Institut za patologiju, Beograd, Srbija
Gorana Nikolić Univerzitet u Beogradu, Medicinski fakultet, Institut za patologiju, Beograd, Srbija
Aleksandar Janković Univerzitet u Beogradu, Medicinski fakultet; KBC ,,Zvezdara”, Beograd, Srbija
Nikola Bogosavljević Univerzitet u Beogradu, Medicinski fakultet; Institut za ortopediju ,,Banjica“ , Beograd, Srbija
Petar Đurić Univerzitet u Beogradu, Medicinski fakultet; KBC ,,Zvezdara”, Beograd, Srbija
Novica Boričić Univerzitet u Beogradu, Medicinski fakultet, Institut za patologiju, Beograd, Srbija
Maja Životić Univerzitet u Beogradu, Medicinski fakultet, Institut za patologiju, Beograd, Srbija

DOI: https://doi.org/10.5937/smclk4-46516

Ključne reči: NCAM eksprimirajuće ćelije, intersticijska fibroza, bubrežno oštećenje, prediktori

Sažetak

Uvod: U zdravim adultnim bubrezima diferentovane tubulske epitelne ćelije ne eksprimiraju neuralni ćelijski adhezioni molekul (engl. neural cell adhesion molecule – NCAM), dok se malobrojne NCAM eksprimirajuće ćelije mogu detektovati u bubrežnom intersticijumu. Uloga i značaj ovih ćelija još nisu razjašnjeni, ali je primećeno da se broj NCAM eksprimirajućih ćelija povećava u stadijumu početne intersticijske fibroze.

Cilj rada: Cilj rada je da se ispita značaj ekspresije NCAM molekula u intersticijumu bubrega kod etiološki različitih oboljenja sa različitim stepenom intersticijske fibroze i da se definišu patohistološki i klinički pokazatelji (prediktori) oštećenja funkcije bubrega.

Materijal i metode: Ispitivanje je obuhvatilo 69 pacijenata kojima su iglene biopsije bubrega urađene tokom 2011. i 2012. godine. Prikupljeni su klinički i laboratorijski podaci u vreme biopsije i u vreme poslednjeg kontrolnog pregleda. Patohistološke karakteristike definisane su optičko-mikroskopski, dok su imunohistohemijskim bojenjem, korišćenjem primarnog NCAM antitela (1:50, klon 123C3.D5), detektovane NCAM eksprimirajuće intersticijske ćelije.

Rezultati: NCAM eksprimirajuće intersticijske ćelije detektovane su u 59,4% biopsija bubrega, a prisustvo ovih ćelija bilo je značajno češće u početnim fazama intersticijske fibroze nego u drugim stadijumima (p < 0,001) i nije zavisilo od patohistološke dijagnoze (p = 0,995). Pacijenti kod kojih su detektovane NCAM ćelije imali su znatno niže vrednosti proteinurije u vreme biopsije u odnosu na pacijente bez NCAM intersticijskih ćelija (p = 0,024). Vrednosti serumskog kreatinina (p < 0,001) i uree (p = 0,007) značajno su uticale na verovatnoću pogoršanja bubrežne funkcije.

Zaključak: Prisustvo NCAM ćelija u u intersticijumu bubrega je karakteristika ranih faza hroničnih bolesti bubrega sa početnom intersticijskom fibrozom i blažim stepenom proteinurije.

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