实用器官移植电子杂志 ›› 2026, Vol. 14 ›› Issue (2): 137-143.DOI: 10.3969/j.issn.2095-5332.2026.02.009

• 论著 • 上一篇    下一篇

衰老近端小管上皮细胞评估肾移植患者预后的价值

李恒睿,向伦理,李其宣,陈丽萍,朱龙银,徐小松,赵洪雯   

  1. 陆军军医大学第一附属医院肾脏内科,重庆 400038
  • 出版日期:2026-03-20 发布日期:2026-03-20
  • 基金资助:

    国家自然科学基金(82470787);

    全军临床重点专科建设(51561Z24B4)

The value of senescent proximal tubular epithelial cells in assessing the prognosis of kidney transplant recipients 

Li Hengrui,Xiang Lunli,Li Qixuan,Chen Liping,Zhu Longyin,Xu Xiaosong,Zhao Hongwen.   

  1. Department of Nephrology,The First Afiliated Hospital ofArmy Medical University,Chongqing 400038,China.

  • Online:2026-03-20 Published:2026-03-20

摘要:

目的 探究衰老近端小管上皮细胞(senescent proximal tubular epithelial cells,sPTECs)对活体亲属肾移植受者肾脏预后的价值。 方法 采用单中心回顾性队列研究,纳入2021 年1 月至2025 年1 月陆军军医大学第一附属医院接受活体亲属供肾移植的135 例受者,分为移植物功能稳定组(n=83)和功能恶化组(n=52)。对供肾和移植物功能恶化组术后3、6、12、18 个月的肾活检组织进行肾小管萎缩(tubular atrophy,TA)及间质纤维化(interstitial fibrosis,IF)评估,同时对衰老标志物γ-H2AX、P21、 P 16 进行检测,分析sPTECs 与肾脏不良修复之间的关系。 结果 与供肾零点活检对比分析发现,功能恶化组TA 及IF 在术后12 个月显著恶化(P<0.05)。γ-H2AX、P 16、P21 的相对表达均在术后6 个月显著高表达(P<0.001)。相关性分析显示,衰老标志物均与TA 及IF 面积显著正相关。结论 PTECs 衰老与活体亲属移植受者肾脏慢性病理损伤程度显著正相关,且发生时间早于病理结构改变,PTECs 衰老可能成为评估活体亲属移植受者肾脏预后的重要指标。

关键词:

text-indent:0pt, vertical-align:middle, "> 近端小管上皮细胞, 衰老, 活体亲属肾移植, 预后评估

Abstract:

Objective To investigate the role of senescent proximal tubular epithelial cells(sPTECs) in predicting renal outcomes in living-related kidney transplant recipients. Methods In this single center retrospective cohort study,135 recipients were divided into stable(n=83)and deteriorating graft function(n=52) groups. Donor kidneys and posttransplant biopsies(3,6,12,18 months)from the deterioration group were assessed for tubular atrophy(TA)and interstitial fibrosis(IF),along with senescence markers(γ-H2AX,P21,P 16),to analyze their association with adverse renal repair. Results Compared with donor baseline,TA and IF areas increased progressively from 12 months posttransplant(P<0.05). Expression of γH2AX,P21,and P 16 increased earlier,showing significant differences from 6 months(P<0.001). All senescence markers positively correlated with TA and IF extent. Conclusion PTEC senescence is positively correlated with the degree of chronic renal histopathological injury in living-related transplant recipients and occurs earlier than structural changes. sPTECs mayserve as a potential biomarker for evaluating renal prognosis in this population.

Key words:

text-indent:0pt, vertical-align:middle, "> Proximal tubular epithelial cells, Senescence, Living-related donor kidneytransplantation, Prognosis assessment