Ishigame H
Department of Pathology, Shinshu University School of Medicine.
Nihon Jinzo Gakkai Shi. 1991 Feb;33(2):105-18.
Glomerular clearing system was histologically studied to see what role it played in the flourishing, resolving and healing stages of Arthus-type nephritis in rabbits with intravenously injected colloidal carbon or ligation of thoracic duct. In the glomerulus, poorly soluble immune complexes were found within mesangial channels, a route for the egress of macromolecules from the peripheral mesangium through the hilus into the juxtaglomerular apparatus, other than phagocytosed by polymorphonuclear leukocytes. However, in the flourishing stage the immune deposits supplied to the external mesangial matrix seemed to originate in that made in the periglomerular blood capillary. Severer glomerulitis was observed under the condition of lymph stasis and juxta-glomerulitis, which was composed of inactive monocytes and plasmocytes, appeared late from the resolving stage. Coincidentally, stagnant amorphous, electron dense material was seen around the border between the external and internal mesangium or the wall of the efferent arteriole at the reflection site of Bowman's capsule. These features of juxta-glomerulitis may be explained by stagnant deposits transported upstream through mesangial channels. Carbon particles within mesangial channels were finally taken up by mesangial cells, whose endocytotic phagosome settled down until three weeks of the healing stage. Mesangial blebs or pseudopods protruding in the capillary lumen were observed in the resolving stage, the injection of colloidal carbon and the ligation of thoracic duct. The endothelium was lifted by mesangial blebs from the juxta-mesangial portion and seemed to interrupt the capillary blood stream. Mesangial influx was increased because of partly desquamation of the endothelium and macromolecules tended to accumulate in the sub-basement membrane of the para-mesangium. It's suggested that focal segmental sclerotic and adhesive lesions in the healing stage are correlated with the degree of juxta-glomerulitis and the peripheral mesangial blebs.
对肾小球清除系统进行了组织学研究，以观察其在静脉注射胶体碳或结扎胸导管的兔阿瑟斯型肾炎的发展、消退和愈合阶段中所起的作用。在肾小球中，除了被多形核白细胞吞噬外，在系膜通道内发现了难溶性免疫复合物，系膜通道是大分子从外周系膜通过肾门进入球旁器的出口途径。然而，在发展阶段，供应到外侧系膜基质的免疫沉积物似乎起源于肾小球周围毛细血管中的沉积物。在淋巴淤滞的情况下观察到更严重的肾小球炎，而由非活性单核细胞和浆细胞组成的球旁炎在消退阶段后期出现。巧合的是，在鲍曼囊反射部位的外侧和内侧系膜之间的边界或出球小动脉壁周围可见停滞的无定形、电子致密物质。球旁炎的这些特征可以用通过系膜通道向上游运输的停滞沉积物来解释。系膜通道内的碳颗粒最终被系膜细胞摄取，其胞吞吞噬体一直存在到愈合阶段的三周。在消退阶段、注射胶体碳和结扎胸导管时，观察到系膜泡或假足突入毛细血管腔。系膜泡将内皮从近系膜部分抬起，似乎中断了毛细血管血流。由于内皮部分脱落，系膜内流增加，大分子倾向于在系膜旁基底膜下积聚。有人认为，愈合阶段的局灶节段性硬化和粘连性病变与球旁炎的程度和外周系膜泡有关。
