Holdsworth S R, Tipping P G
J Clin Invest. 1985 Oct;76(4):1367-74. doi: 10.1172/JCI112112.
Glomerular fibrin deposition is important in the pathogenesis of renal failure and crescent formation in glomerulonephritis. The mechanisms of glomerular fibrin deposition are unknown. The current studies explored the role of macrophages in this process. Methods were developed for measuring glomerular fibrin deposition and glomerular procoagulant activity in a passive model of the autologous phase of antiglomerular basement membrane antibody-induced glomerulonephritis in rabbits. Significant fibrin deposition was observed to be associated with glomerular macrophage accumulation. Leukocyte ablation with mustine hydrochloride prevented both glomerular macrophage accumulation and fibrin deposition without affecting the coagulation system or the deposition of disease-inducing antibodies and complement. Repletion with mononuclear inflammatory cells produced significant fibrin deposition. To examine the role of tissue injury per se in glomerular fibrin deposition, a macrophage-independent model of glomerular injury (heterologous phase glomerulonephritis) was also studied. Although a similar degree of glomerular injury occurred, there was no significant fibrin deposition. This suggests that macrophages, rather than injury alone, are responsible for fibrin deposition. Lysates of isolated glomeruli containing macrophages demonstrated greatly enhanced procoagulant activity compared with lysates of glomeruli without macrophages. Thus macrophages appear to be directly responsible for glomerular fibrin deposition in antiglomerular basement membrane antibody-induced glomerulonephritis, and this appears to be due to their ability to express procoagulant activity rather than their propensity to cause glomerular injury.
肾小球纤维蛋白沉积在肾衰竭发病机制及肾小球肾炎新月体形成中具有重要作用。肾小球纤维蛋白沉积的机制尚不清楚。目前的研究探讨了巨噬细胞在此过程中的作用。已开发出方法来测量兔抗肾小球基底膜抗体诱导的肾小球肾炎自身期被动模型中的肾小球纤维蛋白沉积和肾小球促凝活性。观察到显著的纤维蛋白沉积与肾小球巨噬细胞积聚有关。用盐酸氮芥进行白细胞清除可防止肾小球巨噬细胞积聚和纤维蛋白沉积,而不影响凝血系统或致病抗体及补体的沉积。用单核炎性细胞补充可产生显著的纤维蛋白沉积。为了研究组织损伤本身在肾小球纤维蛋白沉积中的作用,还研究了一种不依赖巨噬细胞的肾小球损伤模型(异种期肾小球肾炎)。尽管发生了相似程度的肾小球损伤,但没有显著的纤维蛋白沉积。这表明是巨噬细胞而非单纯的损伤导致了纤维蛋白沉积。与不含巨噬细胞的肾小球裂解物相比,含有巨噬细胞的分离肾小球裂解物显示出大大增强的促凝活性。因此,在抗肾小球基底膜抗体诱导的肾小球肾炎中,巨噬细胞似乎直接导致了肾小球纤维蛋白沉积,而这似乎是由于它们表达促凝活性的能力,而非它们引起肾小球损伤的倾向。