Osicka Tanya M, Strong Kimberley J, Nikolic-Paterson David J, Atkins Robert C, Jerums George, Comper Wayne D
Endocrine Unit, Austin & Repatriation Medical Centre, Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia.
Nephrol Dial Transplant. 2004 Feb;19(2):320-8. doi: 10.1093/ndt/gfg226.
Plasma albumin has been considered as important for governing glomerular permselectivity as well as being tubulotoxic in proteinuric states. The purpose of this study was to examine glomerular permselectivity and protein clearance of plasma albumin-deficient Nagase analbuminaemic rats (NAR) in normal and proteinuric states associated with puromycin aminonucleoside nephrosis (PAN) and anti-glomerular basement membrane glomerulonephritis (anti-GBM GN) and to compare the results with those of previous studies using Sprague-Dawley rats.
Glomerular permselectivity was measured using tritium-labelled polydisperse Ficoll. In vivo fractional clearance (FC) of albumin, transferrin and immunoglobulin G was measured to include both intact and degraded forms of filtered material. Endogenous protein clearance was analysed using two-dimensional electrophoresis in combination with matrix-assisted laser desorption ionization (MALDI) mass spectrometry.
FCs of proteins and Ficoll in control NAR were similar to those found in Sprague-Dawley rats. Despite the lack of serum albumin in NAR, proteinuria and morphological changes observed were also similar to those found in Sprague-Dawley rats, with total protein excretion increasing 6-fold in PAN rats and 4-fold in anti-GBM GN rats with respect to controls. Two-dimensional electrophoresis in combination with MALDI mass spectrometry identified the major proteins being excreted as transferrin and a group of mildly acidic proteins in the MW range 40-50 kDa, namely antithrombin III, kininogen, alpha-1-antiproteinase, haemopexin and vitamin D-binding protein.
Both diseases exhibited similar effects to those observed in Sprague-Dawley rats despite the lack of serum albumin, including inhibition of renal protein degradation. The net changes in protein FC, particularly in the range of radii of 36-55 A, could not be accounted for by changes in size selectivity as Ficoll FC was little affected by the disease states. This emphasizes the need to reassess the relative importance of changes in renal tubular handling vs changes in glomerular capillary barrier in proteinuric states. These studies also demonstrate that albumin is not a critical factor in governing glomerular permselectivity or proteinuria.
血浆白蛋白被认为对于维持肾小球滤过屏障的选择性很重要,并且在蛋白尿状态下具有肾小管毒性。本研究的目的是检测血浆白蛋白缺乏的长谷川无白蛋白血症大鼠(NAR)在正常状态以及与嘌呤霉素氨基核苷肾病(PAN)和抗肾小球基底膜肾小球肾炎(抗GBM GN)相关的蛋白尿状态下的肾小球滤过屏障选择性和蛋白质清除情况,并将结果与先前使用Sprague-Dawley大鼠的研究结果进行比较。
使用氚标记的多分散性Ficoll测量肾小球滤过屏障选择性。测量白蛋白、转铁蛋白和免疫球蛋白G的体内分数清除率(FC),以包括过滤物质的完整形式和降解形式。使用二维电泳结合基质辅助激光解吸电离(MALDI)质谱分析内源性蛋白质清除情况。
对照NAR中蛋白质和Ficoll的FC与Sprague-Dawley大鼠中的相似。尽管NAR缺乏血清白蛋白,但观察到的蛋白尿和形态学变化也与Sprague-Dawley大鼠中的相似,PAN大鼠的总蛋白排泄量相对于对照增加了6倍,抗GBM GN大鼠增加了4倍。二维电泳结合MALDI质谱鉴定出排泄的主要蛋白质为转铁蛋白和一组分子量在40-50 kDa范围内的轻度酸性蛋白质,即抗凝血酶III、激肽原、α-1抗蛋白酶、血红素结合蛋白和维生素D结合蛋白。
尽管缺乏血清白蛋白,但这两种疾病表现出与Sprague-Dawley大鼠中观察到的相似效应,包括对肾蛋白质降解的抑制。蛋白质FC的净变化,特别是在半径为36-55 Å的范围内,不能用大小选择性变化来解释,因为Ficoll FC受疾病状态的影响很小。这强调了重新评估肾小管处理变化与蛋白尿状态下肾小球毛细血管屏障变化的相对重要性的必要性。这些研究还表明,白蛋白不是维持肾小球滤过屏障选择性或蛋白尿的关键因素。