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类固醇对兔白细胞介导的肾小球肾炎的不同作用。

Differential effects of steroids on leukocyte-mediated glomerulonephritis in the rabbit.

作者信息

Holdsworth S R, Bellomo R

出版信息

Kidney Int. 1984 Aug;26(2):162-9. doi: 10.1038/ki.1984.150.

Abstract

The effects of steroids on the development of injury in two models of experimental glomerulonephritis (GN), (one mediated by neutrophils, the other by macrophages) were compared. The neutrophil-associated lesion [initiated by heterologous antiglomerular basement membrane (GBM) antibody] was characterized by the development of an exudative endocapillary GN with heavy neutrophil accumulation [mean, 6.9 neutrophils/glomerular cross section (N/GCS) +/- 2.9 SD], minor macrophage infiltration [7.9 macrophages/glomerulus (M/G) +/- 2.2 SD] and heavy proteinuria (1905 mg/24 hr +/- 520 SD). Steroid-treated (methylprednisolone, 2 mg/kg/12 hr i.v.) rabbits developed a marked monocytopenia, mild neutrophilia, and significant reduction in glomerular macrophage accumulation (0.3 M/G 0.02 SD). However, neutrophil accumulation (6.1 N/CGS +/- 2.5 SD), histological appearances, and proteinuria (1820 mg/hr +/- 490 SD) were unaffected. The macrophage-associated model of GN was induced by passive autologous rabbit anti-sheep IgG 15 hr after the injection of a subnephritogenic dose of the same anti-GBM antibody. The glomerular lesion was characterized by a diffuse endocapillary proliferative GN with heavy macrophage infiltration (54 M/G +/- 8 SD), insignificant neutrophil accumulation (0.8 N/GCS 0.02 SD), and the regular development of proteinuria (420 mg/24 hr +/- 80 SD). Steroid-treated rabbits developed a mild neutrophilia and a significant monocytopenia associated with abrogation of glomerular macrophage accumulation (2.3 M/G +/- 0.8 SD). This was associated with the prevention of the development of GN and proteinuria (22 +/- 9.5 SD). Thus, steroids produce monocytopenia and prevent glomerular macrophage accumulation and associated injury whereas neutrophil accumulation and injury is unaffected. These data suggest steroids may have widely varying effects on the outcome of leukocyte-associated experimental GN depending on the nature of the infiltrating cells.

摘要

比较了类固醇对两种实验性肾小球肾炎(GN)模型损伤发展的影响(一种由中性粒细胞介导,另一种由巨噬细胞介导)。中性粒细胞相关病变(由异种抗肾小球基底膜(GBM)抗体引发)的特征是出现渗出性毛细血管内增生性GN,伴有大量中性粒细胞积聚[平均,6.9个中性粒细胞/肾小球横切面(N/GCS)±2.9标准差],少量巨噬细胞浸润[7.9个巨噬细胞/肾小球(M/G)±2.2标准差]和大量蛋白尿(1905毫克/24小时±520标准差)。经类固醇治疗(甲泼尼龙,2毫克/千克/12小时静脉注射)的兔子出现明显的单核细胞减少、轻度中性粒细胞增多,且肾小球巨噬细胞积聚显著减少(0.3个M/G±0.02标准差)。然而,中性粒细胞积聚(6.1个N/CGS±2.5标准差)、组织学表现和蛋白尿(1820毫克/小时±490标准差)未受影响。巨噬细胞相关的GN模型是在注射亚肾炎剂量的相同抗GBM抗体15小时后,通过被动自体兔抗羊IgG诱导产生的。肾小球病变的特征是弥漫性毛细血管内增生性GN,伴有大量巨噬细胞浸润(54个M/G±8标准差),中性粒细胞积聚不明显(0.8个N/GCS±0.02标准差),且蛋白尿呈规律性发展(420毫克/24小时±80标准差)。经类固醇治疗的兔子出现轻度中性粒细胞增多和明显的单核细胞减少,同时肾小球巨噬细胞积聚消失(2.3个M/G±0.8标准差)。这与预防GN和蛋白尿的发展相关(22±9.5标准差)。因此,类固醇可导致单核细胞减少,预防肾小球巨噬细胞积聚及相关损伤,而中性粒细胞积聚和损伤不受影响。这些数据表明,类固醇对白细胞相关实验性GN结果的影响可能因浸润细胞的性质而有很大差异。

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