Scherberich J E, Mondorf W A
Z Gesamte Inn Med. 1983 Nov 1;38(21):571-80.
A possible tubulotoxicity of drugs can be judged with the help of the excretion of tubular membrane proteins in the urine. The brush border of the proximal tubular epithelia which react particularly sensitive to toxic influences contains surface antigens which easily release themselves from the membrane core membrane under pathological conditions and become provable in the urine by means of biochemical and immunological methods as signs of an early structural cell damage. Apart from these soluble membrane proteins which above all correspond to enzymes such as alanine aminopeptidase and gamma-glutamyl transpeptidase in severe lesions high molecular brush border fragments transformed to vesicles can appear. The clinical relevance of a pathological tissue proteinuria (histuria) of proteins of renal membranes is among others explained at the instance of the renal effects of cytostatics, antibiotics and x-ray contrast medias.
药物可能的肾小管毒性可借助尿中肾小管膜蛋白的排泄情况来判断。近端肾小管上皮细胞的刷状缘对毒性影响特别敏感,其含有表面抗原,在病理条件下这些抗原容易从膜核心膜释放出来,并通过生化和免疫方法在尿中得以证实,作为早期细胞结构损伤的标志。除了这些主要对应于丙氨酸氨基肽酶和γ-谷氨酰转肽酶等酶的可溶性膜蛋白外,在严重病变时还会出现转化为囊泡的高分子量刷状缘片段。肾膜蛋白的病理性组织蛋白尿(组织尿)的临床相关性,尤其可通过细胞毒性药物、抗生素和X线造影剂对肾脏的影响来说明。