Fogo A, Yoshida Y, Glick A D, Homma T, Ichikawa I
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
J Clin Invest. 1988 Jul;82(1):322-30. doi: 10.1172/JCI113590.
We have recently developed a micropuncture technique to assess repeatedly function of the same nephrons in chronic renal disease and subsequently examine the morphology of their glomeruli by serial thin-section histological analysis. Using this approach, a potential causal linkage between early functional patterns and late structural abnormalities was examined in glomeruli of two established rat models of glomerular sclerosis. The models are (a) puromycin aminonucleoside (PAN) administration in unilaterally nephrectomized Munich-Wistar rats and (b) adriamycin (ADM) treatment in nonnephrectomized Munich-Wistar rats. Single nephron GFR (SNGFR) and glomerular capillary hydraulic pressure (PGC) were measured repeatedly for 8 (PAN rats) or 31 wk (ADM rats). In all animals studied, values for PGC remained at, or slightly below, levels measured before PAN or ADM administration. SNGFR values declined progressively in all glomeruli in PAN rats. Although some glomeruli in ADM rats had an increase in SNGFR above levels observed in nonnephrectomized control rats, these hyperfiltering glomeruli did not have abnormally high PGC nor did they exhibit glomerular sclerosis at the completion of the study. Histological analysis revealed the existence of a significant inverse correlation between the degree of sclerosis and SNGFR assessed at the time of sacrifice in both PAN and ADM groups. Chronic administration of captopril, an angiotensin I converting enzyme inhibitor, in PAN rats substantially attenuated development of glomerular sclerosis without affecting PGC in earlier stages. The observations in these models indicate that glomerular hyperfiltration and hypertension are not required for the development of glomerular sclerosis in renal diseases, and angiotensin I converting enzyme inhibitor can exert its protective effect independently of its effect on glomerular capillary pressure.
我们最近开发了一种微穿刺技术,用于反复评估慢性肾病中同一肾单位的功能,随后通过连续薄切片组织学分析来检查其肾小球的形态。使用这种方法,在两种已建立的肾小球硬化大鼠模型的肾小球中,研究了早期功能模式与晚期结构异常之间的潜在因果联系。这两种模型分别是:(a) 在单侧肾切除的慕尼黑 - 威斯塔大鼠中给予嘌呤霉素氨基核苷(PAN);(b) 在未行肾切除的慕尼黑 - 威斯塔大鼠中给予阿霉素(ADM)。对PAN大鼠进行了8周、对ADM大鼠进行了31周的单肾单位肾小球滤过率(SNGFR)和肾小球毛细血管液压(PGC)的反复测量。在所有研究的动物中,PGC值保持在PAN或ADM给药前测量的水平或略低于该水平。PAN大鼠所有肾小球的SNGFR值逐渐下降。虽然ADM大鼠的一些肾小球SNGFR高于未行肾切除的对照大鼠中观察到的水平,但这些高滤过的肾小球PGC并没有异常升高,并且在研究结束时也未表现出肾小球硬化。组织学分析显示,在PAN和ADM组中,处死时评估的硬化程度与SNGFR之间存在显著的负相关。在PAN大鼠中慢性给予血管紧张素I转换酶抑制剂卡托普利,可显著减轻肾小球硬化的发展,且在早期阶段不影响PGC。这些模型中的观察结果表明,肾小球硬化在肾脏疾病发展过程中并不需要肾小球高滤过和高血压,并且血管紧张素I转换酶抑制剂可以独立于其对肾小球毛细血管压力的影响发挥其保护作用。