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

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