Camici Marcello
Internal Medicine Department, Pisa University, Via Roma, 6, 56126 Pisa, Italy.
Biomed Pharmacother. 2005 Jan-Feb;59(1-2):30-7. doi: 10.1016/j.biopha.2004.06.003. Epub 2005 Jan 20.
The glomerular barrier is the kidney's physical block to the unrestricted flow of molecules from the plasma into the urinary space. Its exquisite selectivity allows solutes and water in the glomerular capillaries to pass through but it prevents the bulk of plasma proteins, most notably albumin, from crossing. Classically the barrier consists of three components: glomerular endothelium, glomerular basement membrane and glomerular epithelium (podocytes) with slit diaphragm. A lot of investigations are experimental but they are sufficient to show the pivotal role of endothelium in glomerular proteinuria. In this study the author discuss glomerular endothelium with particular emphasis on the barrier presumed to be imparted by endothelium-glomerular basement membrane-podocyte interactions. By specialized glomerular endothelial structure (caveolae, tight junctions, endothelium glycocalyx) and by circulating permeability factors (albumin, orosomucoid, apolipoproteins, Amadori's products). Concluding remarks underline the significance to study the glomerular vascular endothelial dysfunction.
肾小球屏障是肾脏阻止分子从血浆无限制地流入尿液空间的物理屏障。其极高的选择性允许肾小球毛细血管中的溶质和水通过，但能阻止大部分血浆蛋白，尤其是白蛋白通过。传统上，该屏障由三个部分组成：肾小球内皮、肾小球基底膜和带有裂孔隔膜的肾小球上皮（足细胞）。许多研究是实验性的，但足以表明内皮在肾小球蛋白尿中的关键作用。在本研究中，作者讨论了肾小球内皮，特别强调了推测由内皮-肾小球基底膜-足细胞相互作用赋予的屏障。通过特殊的肾小球内皮结构（小窝、紧密连接、内皮糖萼）以及循环通透性因子（白蛋白、血清类黏蛋白、载脂蛋白、阿马多里产物）。结论强调了研究肾小球血管内皮功能障碍的重要性。
