Couser W G, Steinmuller D R, Stilmant M M, Salant D J, Lowenstein L M
J Clin Invest. 1978 Dec;62(6):1275-87. doi: 10.1172/JCI109248.
The development of immune deposits on the subepithelial surface of the glomerular capillary wall was studied in isolated rat kidneys perfused at controlled perfusion pressure, pH, temperature, and flow rates with recirculating oxygenated perfusate containing bovine serum albumin (BSA) in buffer and sheep antibody to rat proximal tubular epithelial cell brush border antigen (Fx1A). Control kidney were perfused with equal concentrations of non-antibody immunoglobulin (Ig)G. Renal function was monitored by measuring inulin clearance, sodium reabsorption, and urine flow as well as BSA excretion and fractional clearance. Perfused kidneys were studied by light, immunofluorescence, and electron microscopy. All kidneys perfused with anti-Fx1A developed diffuse, finely granular deposits of IgG along the glomerular capillary wall by immunofluorescence. Electron microscopy revealed these deposits to be localized exclusively in the subepithelial space and slit pores. Similar deposits were produced in a nonrecirculating perfusion system, thereby excluding the formation of immune complexes in the perfusate caused by renal release of tubular antigen. Control kidneys perfused with nonantibody IgG did not develop glomerular immune deposits. Renal function and BSA excretion were the same in experimental and control kidneys. Glomerular deposits in antibody perfused kidneys were indistinguishable from deposits in rats injected with anti-Fx1A or immunized with Fx1A to produce autologous immune complex nephropathy. These studies demonstrate that subepithelial immune deposits can be produced in the isolated rat kidney by perfusion with specific antibody to Fx1A in the absence of circulating immune complexes. In this model deposits result from in situ complex formation rather than circulating immune complex deposition.
在控制灌注压力、pH值、温度和流速的条件下,用含有牛血清白蛋白(BSA)的缓冲液和抗大鼠近端肾小管上皮细胞刷状缘抗原(Fx1A)的羊抗体的循环充氧灌注液对离体大鼠肾脏进行灌注,研究肾小球毛细血管壁上皮下表面免疫沉积物的形成。对照肾脏用等浓度的非抗体免疫球蛋白(Ig)G进行灌注。通过测量菊粉清除率、钠重吸收、尿流以及BSA排泄和分数清除率来监测肾功能。通过光学显微镜、免疫荧光显微镜和电子显微镜对灌注后的肾脏进行研究。所有用抗Fx1A灌注的肾脏通过免疫荧光显示沿肾小球毛细血管壁有弥漫性、细颗粒状的IgG沉积物。电子显微镜显示这些沉积物仅局限于上皮下间隙和裂孔。在非循环灌注系统中也产生了类似的沉积物,从而排除了由肾小管抗原的肾脏释放导致灌注液中形成免疫复合物的可能性。用非抗体IgG灌注的对照肾脏未形成肾小球免疫沉积物。实验肾脏和对照肾脏的肾功能及BSA排泄情况相同。抗体灌注肾脏中的肾小球沉积物与注射抗Fx1A或用Fx1A免疫以产生自体免疫复合物肾病的大鼠中的沉积物无法区分。这些研究表明,在没有循环免疫复合物的情况下,通过用抗Fx1A特异性抗体灌注离体大鼠肾脏可产生上皮下免疫沉积物。在该模型中,沉积物是由原位复合物形成而非循环免疫复合物沉积所致。