Fujiwara Y
Virchows Arch A Pathol Anat Histopathol. 1984;405(1):11-24. doi: 10.1007/BF00694922.
In order to investigate the significance of the histological change in glomerular epithelial cells in minimal change nephrotic syndrome in man (MCNS) and to help in clarifing the mechanism of action of a steroid in this disease, methylprednisolone was administered to rats with puromycin aminonucleoside nephrosis (PAN). This is an experimental nephrosis having a close resemblance morphologically and physiologically, to human MCNS. Morphological changes in the glomerulus were observed ultrastructurally. The administration of the steroid to PAN rats showed remarkable changes including, rapid disappearance of proteinuria in PAN rats in a manner similer to that seen in human MCNS, and significantly faster recovery of changes in glomerular epithelial cells when compared with spontaneous recovery. From the present study, it is clear that the steroid is effective in rapidly restoring the normal shape of glomerular epithelial cells in PAN rats. The filtration barrier in the glomerular capillary wall (GCW) is also thought to have recovered and proteinuria is cured. Based on these considerations, it may be suggested that proteinuria in human MCNS is caused by changes in glomerular epithelial cells, and that the clinical treatment of proteinuria in MCNS is effective when glomerular epithelial cells have functionally recovered.
为了研究人类微小病变肾病(MCNS)中肾小球上皮细胞组织学变化的意义,并有助于阐明类固醇在该疾病中的作用机制,将甲基强的松龙给予嘌呤霉素氨基核苷肾病(PAN)大鼠。这是一种在形态和生理上与人类MCNS极为相似的实验性肾病。通过超微结构观察肾小球的形态变化。给PAN大鼠施用类固醇后出现了显著变化,包括PAN大鼠蛋白尿迅速消失,其方式与人类MCNS中所见相似,并且与自发恢复相比,肾小球上皮细胞变化的恢复明显更快。从本研究可以清楚地看出,类固醇能有效快速恢复PAN大鼠肾小球上皮细胞的正常形态。肾小球毛细血管壁(GCW)的滤过屏障也被认为已经恢复,蛋白尿得以治愈。基于这些考虑,可能提示人类MCNS中的蛋白尿是由肾小球上皮细胞变化引起的,并且当肾小球上皮细胞功能恢复时,MCNS中蛋白尿的临床治疗是有效的。