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实验性诱导犬急性犬埃立克体感染时肾小球病变的研究。

Investigation of glomerular lesions in dogs with acute experimentally induced Ehrlichia canis infection.

作者信息

Codner E C, Caceci T, Saunders G K, Smith C A, Robertson J L, Martin R A, Troy G C

机构信息

Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg 24061.

出版信息

Am J Vet Res. 1992 Dec;53(12):2286-91.

PMID:1476309
Abstract

Six male Beagles were inoculated with Ehrlichia canis. Transient proteinuria was confirmed during the acute phase of infection by serial determination of urinary protein-to-creatinine ratio. Peak urine protein loss, consisting principally of albumin, was observed 2.5 to 3.5 weeks after inoculation. Renal biopsy specimens were obtained before inoculation, during peak proteinuria, and 10 weeks after inoculation when proteinuria had resolved. Renal tissue was evaluated by use of light, immunofluorescent, and electron microscopy to correlate specific glomerular lesions with development of proteinuria. Histologic examination revealed perivenular and interstitial infiltrates of lymphocytes and plasma cells localized principally to the renal cortex. Glomerular lesions were minimal to absent. Immunofluorescent staining revealed moderate to marked deposition of anti-canine IgG and IgM in the glomerular tufts and mesangium. Depositions of anti-canine complement factor C3 were not observed. Immunofluorescent staining persisted 10 weeks after inoculation, despite resolution of proteinuria, and probably represented passive trapping of immunoglobulins. Ultrastructural examination revealed fusion of podocyte processes that coincided with development of proteinuria. Electron-dense deposits or changes in the basement membrane were not observed. Morphometric measurements of average podocyte process length and percentage of coverage of basement membrane by podocyte processes were used to quantify the degree of process fusion. Both measurements increased significantly (P < 0.05) during peak proteinuria, and returned to preinoculation values when proteinuria had resolved 10 weeks after E canis inoculation. These findings indicated possible minimal-change glomerulopathy, rather than immune-complex glomerulonephritis, during acute E canis infection and could explain transient proteinuria without histologic evidence of glomerular disease.

摘要

六只雄性比格犬接种了犬埃立克体。通过连续测定尿蛋白与肌酐比值,在感染急性期确认存在短暂性蛋白尿。接种后2.5至3.5周观察到尿蛋白丢失峰值,主要由白蛋白组成。在接种前、蛋白尿峰值期以及接种后10周蛋白尿消退时获取肾活检标本。使用光学显微镜、免疫荧光显微镜和电子显微镜对肾组织进行评估,以将特定的肾小球病变与蛋白尿的发生相关联。组织学检查显示,淋巴细胞和浆细胞的血管周和间质浸润主要局限于肾皮质。肾小球病变轻微或无病变。免疫荧光染色显示抗犬IgG和IgM在肾小球毛细血管袢和系膜中有中度至明显沉积。未观察到抗犬补体因子C3的沉积。尽管蛋白尿已消退,但免疫荧光染色在接种后10周仍持续存在,可能代表免疫球蛋白的被动滞留。超微结构检查显示足细胞突起融合,与蛋白尿的发生一致。未观察到电子致密沉积物或基底膜变化。使用平均足细胞突起长度和足细胞突起覆盖基底膜百分比的形态计量学测量来量化突起融合程度。在蛋白尿峰值期,这两项测量值均显著增加(P < 0.05),并且在犬埃立克体接种后10周蛋白尿消退时恢复到接种前值。这些发现表明,在急性犬埃立克体感染期间可能存在轻微病变性肾小球病,而非免疫复合物性肾小球肾炎,并且可以解释无肾小球疾病组织学证据的短暂性蛋白尿。

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