Fischer E, Mougenot B, Callard P, Ronco P, Rossert J
INSERM U489, Paris VI University, Assistance Publique-Hôpitaux de Paris, Paris, France.
Nephrol Dial Transplant. 2000 Dec;15(12):1956-64. doi: 10.1093/ndt/15.12.1956.
Proteinuria associated with glomerular diseases is secondary to alterations of the charge-selective and/or size-selective properties of the glomerular basement membrane (GBM), but molecular alterations that are responsible for these functional changes are still poorly understood. Analysis of mice harbouring a null mutation in the gene encoding the beta 2 chain of laminin has suggested that the presence of abnormal laminin chains within the GBM can be responsible for proteinuria.
We have investigated whether abnormal laminin ss chains could be detected by immunohistochemistry within the GBM of patients with proteinuria and minimal change disease (five patients), focal and segmental glomerulosclerosis (five patients), or primary membranous glomerulonephritis (10 patients). Three patients with mesangiocapillary glomerulonephritis and three patients with IgA nephropathy were also studied as controls.
We showed that the GBM of all 10 patients with membranous glomerulonephritis, but not of patients with other glomerulopathies, contained laminin beta 1, which is normally expressed only during metanephros development. The re-expression of the beta 1 chain of laminin was not associated with that of the embryonic alpha 1 chain of type IV collagen, or with the loss of expression of vimentin and synaptopodin, two markers of differentiated podocytes.
The presence of new laminin isoforms within the GBM of patients with membranous glomerulonephritis could play a role in the occurrence of proteinuria, by modifying either the sieving properties of the GBM or the interactions between podocytes and the GBM.
与肾小球疾病相关的蛋白尿继发于肾小球基底膜(GBM)电荷选择性和/或大小选择性特性的改变,但导致这些功能变化的分子改变仍知之甚少。对编码层粘连蛋白β2链的基因发生无效突变的小鼠的分析表明,GBM内异常层粘连蛋白链的存在可能是蛋白尿的原因。
我们研究了通过免疫组织化学是否能在蛋白尿和微小病变病(5例患者)、局灶节段性肾小球硬化症(5例患者)或原发性膜性肾小球肾炎(10例患者)患者的GBM中检测到异常层粘连蛋白β链。还研究了3例系膜毛细血管性肾小球肾炎患者和3例IgA肾病患者作为对照。
我们发现,所有10例膜性肾小球肾炎患者的GBM中都含有层粘连蛋白β1,而其他肾小球疾病患者的GBM中则没有,层粘连蛋白β1通常仅在肾元发育期间表达。层粘连蛋白β1链的重新表达与IV型胶原胚胎α1链的重新表达无关,也与波形蛋白和突触足蛋白(分化足细胞的两个标志物)表达的丧失无关。
膜性肾小球肾炎患者GBM中存在新的层粘连蛋白异构体,可能通过改变GBM的筛分特性或足细胞与GBM之间的相互作用,在蛋白尿的发生中起作用。