Department of Pathology, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2013 Jul 25;8(7):e69253. doi: 10.1371/journal.pone.0069253. Print 2013.
The location of segmental glomerular lesions in relation to the vascular or tubular pole may have diagnostic or prognostic significance. We have developed a model-based method to estimate the distance from a glomerular lesion to a given landmark (vascular or tubular pole) or the glomerular center and applied this to biopsies from 5 microalbuminuric, 5 normoalbuminuric and 7 proteinuric type 1 diabetic patients and 5 normal controls. The distance from each glomerular adhesion to the glomerulotubular junction was measured and divided by the glomerular radius, allowing comparability among different glomeruli, assuming a spherical shape for Bowman's capsule, an assumption which was validated. The frequency of adhesions in 6 glomerular zones with equal height (zone I adjacent to the glomerulotubular junction and zones II-VI progressively farther away) was determined: 59% of adhesions were in zone I, 15% in zone II, 16% in zone III, 7% in zone IV and 3% in zone VI (adjacent to the hilus). In glomeruli with only one adhesion, 82% of these were in zone I. This new method accurately localizes segmental lesions within glomeruli and revealed a marked predilection in type 1 diabetic patients for segmental sclerosis to develop at the glomerulotubular junction.
节段性肾小球病变与血管或管状极的位置关系可能具有诊断或预后意义。我们开发了一种基于模型的方法来估计肾小球病变与给定标志物（血管或管状极）或肾小球中心的距离，并将其应用于 5 例微量白蛋白尿、5 例正常白蛋白尿和 7 例蛋白尿 1 型糖尿病患者和 5 例正常对照的活检。测量了每个肾小球粘连到肾小球小管连接的距离，并除以肾小球半径，假设鲍曼氏囊呈球形，从而在不同肾小球之间具有可比性，这一假设得到了验证。确定了 6 个具有相等高度的肾小球区（紧邻肾小球小管连接的区 I 和逐渐远离的区 II-VI）中粘连的频率：59%的粘连位于区 I，15%位于区 II，16%位于区 III，7%位于区 IV，3%位于区 VI（毗邻门）。在仅有一个粘连的肾小球中，这些粘连中有 82%位于区 I。这种新方法可以准确地定位肾小球内的节段性病变，并揭示 1 型糖尿病患者中节段性硬化在肾小球小管连接处发展的明显偏好。
