Schulze M, Baker P J, Perkinson D T, Johnson R J, Ochi R F, Stahl R A, Couser W G
Department of Medicine, University of Washington, Seattle.
Kidney Int. 1989 Jan;35(1):60-8. doi: 10.1038/ki.1989.8.
Increased urinary excretion of C5b-9 distinguishes passive Heymann nephritis from other forms of experimental glomerulonephritis in the rat. In the passive Heymann nephritis (PHN) model of membranous nephropathy (MN) subepithelial deposits form from anti-Fx1A antibody reacting with antigen expressed on the glomerular epithelial cell membrane followed by membrane patching and shedding of immune complexes. Immune complex deposits are accompanied by deposits of C5b-9 which is required for the mediation of proteinuria. We tested the hypothesis that C5b-9 assembly on the epithelial cell membrane might result in C5b-9 excretion in the urine, which would distinguish this autoimmune mechanism of MN from other processes that result in subepithelial immune complex deposits. Using monoclonal antibodies developed to rat C6 and a rat C5b-9 neoantigen, in a sensitive ELISA assay, elevated urinary excretion of rat C5b-9 was documented in PHN associated with on-going glomerular immune deposit formation. No urinary C5b-9 was detectable in MN induced by an exogenous antigen (cationized IgG) despite equivalent glomerular C5b-9 deposits, or in models of nephrotoxic nephritis, subendothelial immune complex nephritis, anti-mesangial cell membrane antibody-induced nephritis or two non-immune nephropathies. Infusion of preformed C5b-9 in proteinuric animals excluded glomerular filtration of C5b-9 as a contributing mechanism to urinary C5b-9 excretion. We conclude that in the rat, increased urinary excretion of C5b-9 is a marker of MN induced by antibody to a glomerular epithelial cell antigen. Urine C5b-9 excretion reflects active glomerular immune deposit formation and distinguishes MN induced by this mechanism from other forms of MN as well as from other glomerular diseases with equivalent glomerular C5b-9 deposits.
C5b - 9尿排泄增加可将大鼠被动型海曼肾炎与其他形式的实验性肾小球肾炎区分开来。在膜性肾病(MN)的被动型海曼肾炎(PHN)模型中,抗Fx1A抗体与肾小球上皮细胞膜上表达的抗原反应后形成上皮下沉积物,随后是膜修补和免疫复合物脱落。免疫复合物沉积物伴有C5b - 9沉积物,C5b - 9是介导蛋白尿所必需的。我们检验了这样一个假设,即上皮细胞膜上C5b - 9的组装可能导致C5b - 9在尿液中排泄,这将把MN的这种自身免疫机制与导致上皮下免疫复合物沉积的其他过程区分开来。在一项灵敏的酶联免疫吸附测定(ELISA)中,使用针对大鼠C6和大鼠C5b - 9新抗原研制的单克隆抗体,发现在与正在进行的肾小球免疫沉积物形成相关的PHN中,大鼠C5b - 9的尿排泄增加。在外源性抗原(阳离子化IgG)诱导的MN中,尽管肾小球C5b - 9沉积物相当,但未检测到尿C5b - 9,在肾毒性肾炎、内皮下免疫复合物肾炎、抗系膜细胞膜抗体诱导的肾炎模型或两种非免疫性肾病模型中也未检测到。向蛋白尿动物输注预先形成的C5b - 9排除了C5b - 9通过肾小球滤过作为尿C5b - 9排泄的一种促成机制。我们得出结论,在大鼠中,C5b - 9尿排泄增加是由针对肾小球上皮细胞抗原的抗体诱导的MN的一个标志物。尿C5b - 9排泄反映了活跃的肾小球免疫沉积物形成,并将由这种机制诱导的MN与其他形式的MN以及具有相当肾小球C5b - 9沉积物的其他肾小球疾病区分开来。