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社论:主要的肾小球滤过屏障——基底膜还是上皮裂隙?

Editorial: The primary glomerular filtration barrier--basement membrane or epithelial slits?

作者信息

Farquhar M G

出版信息

Kidney Int. 1975 Oct;8(4):197-211. doi: 10.1038/ki.1975.103.

Abstract

In 1961, based on results obtained with the particulate tracer ferritin, Farquhar, Wissig and Palade [15] proposed a functional model for the glomerulus and defined a role for each of its components in the filtration process: a) the basement membrane as the main filter; b) the endothelium as a valve, which by the number and size of its fenestrae, controls access to the filter; c) the epithelium as a monitor which partially recovers proteins that leak through the filter; and d) the mesangium which serves to recondition and unclog the filter by incorporating and disposing of filtration residues which accumulate against it. In 1966, based on results obtained with the histochemically demonstrable tracers, horseradish peroxidase and myeloperoxidase, Graham and Karnovsky [24] questioned the basement membrane as the site of the main filter and proposed instead that it functioned as a crude prefilter with the epithelial slits representing the final critical barrier. While the concept of the "two-barriers-in-series" has enjoyed wide acceptance, the validity of certain of the experimental data used to support the original hypothesis has been questioned [23, 29, 37]. In the meantime, additional experimental evidence obtained largely with the use of particulate tracers (especially dextrans [23, 43, 44]), has provided strong support for the concept that the basement membrane acts as the main barrier to the passage of molecules in the same size range as plasma proteins (32, 000 to 125,000 mol wt). With respect to the function of the other layers in filtration, additional new information that has come to light has supported the roles proposed above. Work with both particulate [16, 60] and enzymatic [24, 29] tracers, as well as studies by Michael et al [61, 62] with aggregated serum ablumin, supported the phagocytic (unclogging) function of the mesangium. There is evidence from work with particulate tracers (particularly that with dextrans in nephrotic animals [43, 44]) which supports the monitoring function proposed for the epithelium. Recognizing that their work with histochemically demonstrable tracers may have certain technical limitations, Karnovsky, Ainsworth and Schneeberger [29, 37, 38] have recently taken the position that there is no definitive answer to the question of which structure-basement membrane or epithelial slits-represents the principal filter, and have suggested that more information is needed in order to make such a decision. But, in fact, the bulk of the evidence available at present favors the basement membrane as the primary filtration barrier in the glomerulus. Substantial evidence based on work with electronopaque tracers (including recent studies with dextrans) indicates retention of a variety of tracers by the basement membrane. On the other hand, unequivocal demonstration of retention of any tracer by the slits is still lacking.

摘要

1961年,基于用颗粒示踪剂铁蛋白获得的结果,法夸尔、维西格和帕拉德[15]提出了肾小球的功能模型,并确定了其各组成部分在滤过过程中的作用:a)基底膜作为主要滤器;b)内皮作为一个瓣膜,通过其窗孔的数量和大小控制对滤器的 access;c)上皮作为一个监测器,部分回收漏过滤器的蛋白质;d)系膜通过摄取和处理积聚在其上的滤过残渣来修复和疏通滤器。1966年,基于用组织化学可显示的示踪剂辣根过氧化物酶和髓过氧化物酶获得的结果,格雷厄姆和卡诺夫斯基[24]对基底膜作为主要滤器的部位提出质疑,转而提出其作为一个粗略的预滤器起作用,而上皮裂隙代表最终的关键屏障。虽然“串联双屏障”的概念已被广泛接受,但用于支持原假设的某些实验数据的有效性受到了质疑[23, 29, 37]。与此同时,主要通过使用颗粒示踪剂(特别是右旋糖酐[23, 43, 44])获得的额外实验证据,为基底膜作为与血浆蛋白大小范围相同(32,000至125,000摩尔重量)的分子通过的主要屏障这一概念提供了有力支持。关于滤过中其他层的功能,新发现的额外新信息支持了上述提出的作用。使用颗粒[16, 60]和酶[24, 29]示踪剂的研究,以及迈克尔等人[61, 62]对聚集血清白蛋白的研究,支持了系膜的吞噬(疏通)功能。有来自使用颗粒示踪剂的研究证据(特别是对肾病动物中右旋糖酐的研究[43, 44])支持了为上皮提出的监测功能。卡诺夫斯基、安斯沃思和施内伯格[29, 37, 38]认识到他们使用组织化学可显示示踪剂的工作可能有某些技术局限性,最近采取的立场是,关于哪个结构——基底膜还是上皮裂隙——代表主要滤器的问题没有确定答案,并建议需要更多信息才能做出这样的决定。但是,事实上,目前可获得的大量证据支持基底膜作为肾小球中的主要滤过屏障。基于使用不透电子示踪剂的工作(包括最近对右旋糖酐的研究)的大量证据表明基底膜保留了多种示踪剂。另一方面,仍然缺乏裂隙保留任何示踪剂的确切证据。

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