Arisz L, Andres G A, Brentjens J R
Ric Clin Lab. 1977 Oct-Dec;7(4):312-27. doi: 10.1007/BF02886645.
The morphological basis of the glomerular permeability to proteins is reviewed and a survey is given of the studies done with ultrastructural tracer substances. In the normal GCW two structures have been considered important as a possible barrier to macromolecules: the GBM and the epithelial slit pore and slit diaphragm. The currently available evidence indicates that under normal conditions most plasma proteins do not penetrate beyond the subendothelial layer of the GCW. However, it is probable that the epithelial slit diaphragm acts as a secomdary barrier to macromolecules. In glomerular proteinurai the transport of anionic macromolecules through the GCW is increased, but the passage of uncharged macromolecules (PVP, dextran) is less than in the normal glomerulus. The number of anionic sites in the GCW is much smaller than in the normal glomerulus and there is a change in the normal arrangement of the foot processes and a decrease in the number of slit pores. At present, it is still incompletely understood in which way these changes are related to each other. Assuming the presence of focal leaks in the GCW, a possible sequence of events leading to glomerular proteinuria is discussed.
本文综述了肾小球对蛋白质通透性的形态学基础，并对使用超微结构示踪物质所做的研究进行了概述。在正常肾小球毛细血管壁（GCW）中，有两种结构被认为是大分子可能的屏障：肾小球基底膜（GBM）和上皮细胞裂孔及裂孔隔膜。目前可得的证据表明，在正常情况下，大多数血浆蛋白不会穿透到GCW的内皮下层之外。然而，上皮细胞裂孔隔膜很可能作为大分子的二级屏障。在肾小球蛋白尿中，阴离子大分子通过GCW的转运增加，但不带电荷的大分子（聚乙烯吡咯烷酮、葡聚糖）的通过量比正常肾小球少。GCW中阴离子位点的数量比正常肾小球少得多，足突的正常排列发生改变，裂孔数量减少。目前，这些变化之间以何种方式相互关联仍未完全明了。假设GCW存在局灶性渗漏，讨论了导致肾小球蛋白尿的可能事件序列。
