Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Am J Physiol Renal Physiol. 2013 Jul 15;305(2):F216-26. doi: 10.1152/ajprenal.00255.2012. Epub 2013 May 1.
Cumulative epidemiological evidence indicates that the presence of microalbuminuria predicts a higher frequency of cardiovascular events, peripheral disease, and mortality in essential hypertension. Microalbuminuria may arise from increased glomerular permeability and/or reduced proximal tubular reabsorption of albumin by receptor-mediated endocytosis. This study aimed to evaluate the temporal pattern of urinary protein excretion and to test the hypothesis that progression of microalbuminuria is associated with decreased protein expression of critical components of the endocytic apparatus in the renal proximal tubule of spontaneously hypertensive rats (SHR). We found that urinary albumin excretion increased progressively with blood pressure in SHR from 6 to 21 wk of age. In addition, SDS-PAGE analysis of urinary proteins showed that microalbuminuric SHR virtually excreted proteins of the size of albumin or smaller (<70 kDa), typical of tubular proteinuria. Moreover, the protein abundance of the endocytic receptors megalin and cubilin as well as of the chloride channel ClC-5 progressively decreased in the renal cortex of SHR from 6 to 21 wk of age. Expression of the vacuolar H⁺-ATPase B2 subunit was also reduced in the renal cortex of 21-wk-old compared with both 6- and 14-wk-old SHR. Collectively, our study suggests that enhanced urinary protein excretion, especially of albumin, may be due, at least in part, to lower expression of key components of the apical endocytic apparatus in the renal proximal tubule. Finally, one may speculate that dysfunction of the apical endocytic pathway in the renal proximal tubule may contribute to the development of microalbuminuria in essential hypertension.
累积的流行病学证据表明,微量白蛋白尿的存在预示着原发性高血压患者心血管事件、外周疾病和死亡率的发生率更高。微量白蛋白尿可能是由于肾小球通透性增加和/或白蛋白通过受体介导的内吞作用的近端肾小管重吸收减少引起的。本研究旨在评估尿蛋白排泄的时间模式,并检验以下假设:微量白蛋白尿的进展与自发性高血压大鼠(SHR)肾近端小管内吞装置关键成分的蛋白表达减少有关。我们发现,从 6 到 21 周龄,SHR 的尿白蛋白排泄量随血压的升高而逐渐增加。此外,尿蛋白的 SDS-PAGE 分析表明,微量白蛋白尿的 SHR 实际上排泄的是白蛋白或更小(<70 kDa)大小的蛋白质,这是肾小管蛋白尿的典型特征。此外,内吞受体 megalin 和 cubilin 以及氯离子通道 ClC-5 的蛋白丰度从 6 到 21 周龄在 SHR 的肾皮质中逐渐降低。与 6 周和 14 周龄的 SHR 相比,21 周龄 SHR 肾皮质中的液泡 H ⁇ -ATPase B2 亚基的表达也减少了。综上所述,我们的研究表明,增强的尿蛋白排泄,特别是白蛋白的排泄,可能至少部分归因于肾近端小管顶泌物内吞装置关键成分的表达降低。最后,人们可能推测,肾近端小管顶泌物内吞途径的功能障碍可能导致原发性高血压中微量白蛋白尿的发生。