Wintour E M, Moritz K M, Johnson K, Ricardo S, Samuel C S, Dodic M
Howard Florey Institute of Experimental Physiology and Medicine, University of Melbourne, Parkville 3010, Victoria, Australia.
J Physiol. 2003 Jun 15;549(Pt 3):929-35. doi: 10.1113/jphysiol.2003.042408. Epub 2003 May 2.
There is some evidence, mainly from rodent studies, that any factor which alters the final total number of nephrons formed, during nephrogenesis, will result in hypertension in adult life. Sheep, programmed to become hypertensive by exposure to synthetic glucocorticoid (dexamethasone, 0.48 mg h-1, for 48 h) early in development (~27 days of gestation), were killed at 7 years of age, and had nephron counting performed by unbiased stereology. Mean arterial pressure was 83 +/- 4 mmHg in the dexamethasone (DEX) group (n = 5), and 73 +/- 5 in the control (CON; n = 7; P < 0.05). The total nephron number, in the right kidney (249 070 +/- 14 331; n = 5) was significantly lower (P < 0.01) than that of controls (402 787 +/- 30 458; n = 7). Mean glomerular volume was larger in the DEX than the CON group (P < 0.01), but there was no significant difference in the sclerosis index between the two groups. Low nephron number was associated with grossly enlarged and dilated proximal tubules and greater accumulation of collagen type I and type III in the tubular interstitium and periadventitia of the renal cortical vessels. These data suggest that the hypertensive programming effect of glucocorticoid treatment, early in kidney development, results, at least in part, from impaired nephrogenesis.
有一些证据(主要来自啮齿动物研究)表明,在肾发生过程中,任何改变最终形成的肾单位总数的因素都会导致成年后高血压。在发育早期(约妊娠27天)通过暴露于合成糖皮质激素(地塞米松,0.48毫克/小时,持续48小时)而被设定为患高血压的绵羊,在7岁时被处死,并通过无偏立体学方法进行肾单位计数。地塞米松(DEX)组(n = 5)的平均动脉压为83±4 mmHg,对照组(CON;n = 7;P < 0.05)为73±5。右肾的总肾单位数(249 070±14 331;n = 5)显著低于对照组(402 787±30 458;n = 7)(P < 0.01)。DEX组的平均肾小球体积大于CON组(P < 0.01),但两组之间的硬化指数无显著差异。肾单位数量少与近端肾小管明显增大和扩张以及肾皮质血管的肾小管间质和外膜中I型和III型胶原蛋白的积累增加有关。这些数据表明,在肾脏发育早期糖皮质激素治疗的高血压编程效应至少部分源于肾发生受损。