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目的:研究骨形态发生蛋白2(BMP2)及成骨样细胞转录因子MSX2在特发性高钙尿(IH)肾结石患者肾乳头组织中的表达,探讨其在IH患者结石形成中的作用机制。方法:筛选特发性高钙尿肾结石患者8例(IH组),排除各种已知可能影响血清钙或尿钙的继发疾病;选择同期因肾肿瘤或非结石所致的无功能肾需行肾切除术的患者8例(NC组)。分别取16例患者肾乳头组织若干,各标本应用实时荧光定量PCR检测BMP2和MSX2mRNA的表达,并应用Western blot测定两组蛋白质表达水平。结果:IH组BMP2的mRNA表达量为1.491±0.121,而NC组BMP2的mRNA为1.032±0.034,两组间表达量差异有统计学意义(P<0.05);而IH组与NC组MSX2的mRNA表达量分别为1.432±0.091和1.015±0.017,两组比较差异有统计学意义(P<0.05)。Western blotting检测BMP2蛋白提示NC组和IH组蛋白质表达量分别为1.475±0.042和1.681±0.153,两组比较差异有统计学意义(P<0.05);测定MSX2蛋白水平表达显示NC组为1.531±0.134,而IH组为1.603±0.156,两者比较差异无明显统计学意义(P>0.05)。结论:IH肾结石患者肾乳头BMP2和MSX2mRNA表达增强为间质异位钙化特征,BMP2信号通路在IH结石患者Randall钙斑形成中具有一定作用。
OBJECTIVE: To study the expression of bone morphogenetic protein 2 (BMP2) and osteoblast-like cell transcription factor MSX2 in renal papilla tissue of idiopathic hypercalciuria (IH) nephrolithiasis and to explore its mechanism in stone formation of patients with IH . Methods: Eight patients with idiopathic hypercalciuria (IH group) were screened to exclude all kinds of secondary diseases known to affect serum calcium or urinary calcium. The non-functional nephrotic Eight patients underwent nephrectomy (NC group). The renal papilla tissues of 16 patients were taken respectively. The expression of BMP2 and MSX2 mRNA in each specimen were detected by real-time fluorescence quantitative PCR. The protein expression levels in both groups were detected by Western blot. Results: The mRNA expression level of BMP2 in IH group was 1.491 ± 0.121, while the mRNA level of BMP2 in NC group was 1.032 ± 0.034, the difference was statistically significant (P <0.05); while the expression of MSX2 mRNA The expression levels were 1.432 ± 0.091 and 1.015 ± 0.017, respectively, with significant difference between the two groups (P <0.05). Western blotting detection of BMP2 protein prompted NC and IH protein expression levels were 1.475 ± 0.042 and 1.681 ± 0.153, the difference between the two groups was statistically significant (P <0.05); determination of MSX2 protein levels showed NC group was 1.531 ± 0.134 , While IH group was 1.603 ± 0.156, there was no significant difference between the two groups (P> 0.05). CONCLUSIONS: The expression of BMP2 and MSX2 mRNA in renal papilla of patients with IH nephrolithiasis is characteristic of interstitial ectopic calcification. The BMP2 signaling pathway may play a role in the formation of Randall calcium spot in patients with IH stone.