Myers B D
Department of Medicine/Nephrology, Stanford University School of Medicine, Calif.
Am J Nephrol. 1990;10 Suppl 1:19-23. doi: 10.1159/000168189.
Uncharged dextrans of graded size (28-60 A) were used to evaluate glomerular barrier size selectivity in 13 nephrotic patients with diffuse proliferative lupus nephritis. Transglomerular sieving was enhanced selectively for dextrans of greater than 46 A radius when the nephritis was active and restored towards normal by immunosuppressive therapy. A mathematical model of hindered solute transport through a porous membrane revealed these findings to reflect the prevalence in the glomerular barrier of a subset of enlarged, nondiscriminatory pores. Although few in number, such enlarged pores accounted for both the magnitude and composition of observed proteinuria. We infer that impaired barrier size selectivity underlies the proteinuria that attends lupus nephritis, and that impairment of barrier charge selectivity need not be invoked in this circumstance.
使用不同大小（28 - 60埃）的不带电荷葡聚糖来评估13例弥漫性增殖性狼疮性肾炎肾病患者的肾小球屏障大小选择性。当肾炎处于活动期时，半径大于46埃的葡聚糖的跨肾小球筛过选择性增强，免疫抑制治疗后恢复正常。一个关于溶质在多孔膜中受阻传输的数学模型表明，这些发现反映了肾小球屏障中存在一部分扩大的、无选择性的孔隙。虽然数量很少，但这些扩大的孔隙解释了观察到的蛋白尿的量和成分。我们推断，屏障大小选择性受损是狼疮性肾炎伴发蛋白尿的基础，在这种情况下无需考虑屏障电荷选择性受损。
