Nagata M, Schärer K, Kriz W
Institut für Anatomie und Zellbiologie und Kinderklinik Universität Heidelberg, Germany.
Kidney Int. 1992 Jul;42(1):136-47. doi: 10.1038/ki.1992.271.
Uninephrectomy (UNX) results in a higher incidence of focal glomerular sclerosis (FGS) in young rats than it does in adults. The reason for this higher susceptibility in young animals is not fully understood, but this does suggest that UNX in young rats may represent a particularly promising model in which to study the development of FGS. In the present study 10-day-old rats were subjected to UNX. After 4, 12 and 24 weeks, glomerular hypertrophy, structural lesions and function were analyzed in comparison with sham-operated controls. Up to the twelfth week, remnant kidney growth and glomerular growth proceeded in parallel; thereafter, kidney growth ceased, whereas glomerular growth continued undiminished. Twenty-four weeks after UNX, glomerular tuft volume in experimental animals exceeded that in controls by 80%. Twelve weeks after surgery, total GFR in UNX rats was approximately 80% of that in controls, a value maintained until the end of the observation period. Twenty-four weeks after surgery, heavy proteinuria was present in UNX animals. Structural abnormalities in glomeruli of UNX animals were already encountered 12 weeks after surgery; they were present to a much lesser extent in controls. In UNX animals these proceeded to the FGS stage by the end of the observation period. Three major groups of glomerular lesions were observed: (1) changes in the width and shape of glomerular capillaries. (2) changes in podocyte structure, and (3) tuft adhesions to Bowman's capsule with or without segmental sclerosis. The structural changes are analyzed in this and an accompanying paper [1]. The present paper deals with the widespread formation of irregular, giant capillary loops. They occur predominantly at the tuft periphery with a clear predilection for the vascular pole region. They are not a result of compensatory growth, but rather an expansion of single capillaries due to failure of the mesangium. Local disconnection of the mesangium from its anchoring points at the GBM leads to bulging and "coalescence" of capillary loops, resulting in abnormally-shaped vascular channels. This process is associated with a rearrangement of the corresponding mesangium. In our view, the appearance of dilated capillaries represents a local event pivotal to the development of more severe lesions, such as tuft adhesions and FGS.
单侧肾切除(UNX)在幼鼠中导致局灶性肾小球硬化(FGS)的发生率高于成年鼠。幼龄动物这种更高易感性的原因尚未完全了解,但这确实表明幼鼠的UNX可能是研究FGS发展的一个特别有前景的模型。在本研究中,对10日龄大鼠进行了UNX。在4、12和24周后,与假手术对照组相比,分析了肾小球肥大、结构损伤和功能。直到第12周,残余肾生长和肾小球生长并行进行;此后,肾脏生长停止,而肾小球生长继续且未减弱。UNX后24周,实验动物的肾小球体积比对照组超出80%。手术后12周,UNX大鼠的总肾小球滤过率(GFR)约为对照组的80%,这一数值在观察期结束前一直维持。手术后24周,UNX动物出现大量蛋白尿。UNX动物的肾小球结构异常在手术后12周就已出现;在对照组中程度要轻得多。在UNX动物中,到观察期结束时这些异常发展到了FGS阶段。观察到三大类肾小球病变:(1)肾小球毛细血管宽度和形状的改变。(2)足细胞结构的改变,以及(3)肾小球与鲍曼囊的粘连,伴有或不伴有节段性硬化。在本文及一篇配套论文[1]中分析了结构变化。本文探讨不规则巨大毛细血管袢的广泛形成。它们主要出现在肾小球周边,明显偏向血管极区域。它们不是代偿性生长的结果,而是由于系膜功能障碍导致单个毛细血管扩张。系膜从其在肾小球基底膜(GBM)的锚定部位局部断开,导致毛细血管袢膨出和“融合”,形成形状异常的血管通道。这一过程与相应系膜的重新排列有关。我们认为,扩张毛细血管的出现是一个局部事件,对更严重病变如肾小球粘连和FGS的发展至关重要。