Blantz R C, Tucker B J, Wilson C B
J Clin Invest. 1978 Apr;61(4):910-21. doi: 10.1172/JCI109016.
Recent studies from this laboratory have revealed that single nephron filtration rate (sngfr) decreases significantly within 1 h of the administration of large doses of complement-fixing antiglomerular basement membrane antibody (AGBM Ab) in plasma-expanded Munich-Wistar rats. This reduction in sngfr was due to decreases in nephron plasma flow (rf) and the glomerular permeability coefficient (LpA) utilizing direct evaluation of all pertinent pressures, flows, and permeabilities. With identical micropuncture techniques, we have determined (a) the respective influences of rpf and LpA upon sngfr by examining the effects of differing doses of AGBM Ab, and (b) the specific effect of complement fixation upon the reduction in sngfr. In normal rats, low dose (1.4 microgram/g body wt) AGBM Ab decreased sngfr from 57.9 +/- 3.4 to 50.8+/- 3.9 nl/min per g kidney wt (kw) (P less than 0.001), and this was due to a 10% reduction in rpf and a decrease in LpA FROM 0.069 +/- 0.014 in control to 0.041 +/- 0.007 nl/s per g kw per mm Hg (P less than 0.02). At the high dose (2.3 microgram/g body wt), sngfr fell dramatically from 58.4 +/- 4.0 to 7.6 +/- 3.8 nl/min per g kw (P less than 0.001), and this effect upon filtration was the result of an 86% reduction in rpf and a decrease in LpA from 0.092 +/- 0.020 to 0.007 +/- 0.004 nl/s per g kw mm Hg (P less than 0.001). Therefore, at lower doses sngfr fell primarily as a result of a 40% reduction in LpA and a 10% decrease in rpf; however, at the high dose massive reductions in both rps and LpA led to the large decrease in sngfr. In complement-depleted rats, receiving identical doses, low-dose AGBM Ab no longer reduced the sngfr, but a reduction in LpA persisted (other factors compensating to maintain sngfr). At the high dose, complement depletion ameliorated the reduction in sngfr (55.1 +/- 2.4 to 37.2 +/- 3.4 nl/min per g kw mm Hg) by nearly eliminating the vasoconstriction but only partially diminished the reduction in LpA (0.097 +/- 0.020 to 0.032 +/- 0.004 nl/s per g kw mm Hg, P less than 0.05). Complement depletion prevented the migration of polymorphonuclear leukocytes (present in larger numbers after the high dose of AGBM Ab) into the capillary and eliminated vasoconstriction. Complement depletion resulted in a lesser effect of high-dose AGBM Ab upon LpA than in normal rats, and this is likely due to lesser polymorphonuclear leukocyte effects upon capillary surface area. The persistent reduction in LpA observed in complement-depleted rats correlated with separation of the endothelial cell from the glomerular basement membrane after AGBM Ab, AGBM Ab diminished glomerular ultrafiltration by decreasing LpA and altering the endothelial surface of the glomerular membrane, and this effect is not totally dependent upon the fixation of complement.
本实验室最近的研究表明,在血浆扩容的慕尼黑-威斯塔大鼠中,给予大剂量补体结合性抗肾小球基底膜抗体(AGBM抗体)后1小时内,单个肾单位滤过率(sngfr)显著降低。sngfr的这种降低是由于利用对所有相关压力、流量和通透性的直接评估,肾单位血浆流量(rf)和肾小球通透系数(LpA)降低所致。采用相同的微穿刺技术,我们确定了:(a)通过检查不同剂量AGBM抗体的作用,rpf和LpA对sngfr的各自影响;(b)补体固定对sngfr降低的具体影响。在正常大鼠中,低剂量(1.4微克/克体重)AGBM抗体使sngfr从57.9±3.4降至50.8±3.9纳升/分钟/克肾重(kw)(P<0.001),这是由于rpf降低10%以及LpA从对照时的0.069±0.014降至0.041±0.007纳升/秒/克kw/毫米汞柱(P<0.02)。在高剂量(2.3微克/克体重)时,sngfr从58.4±4.0急剧降至7.6±3.8纳升/分钟/克kw(P<0.001),这种对滤过的影响是rpf降低86%以及LpA从0.092±0.020降至0.007±0.004纳升/秒/克kw/毫米汞柱(P<0.001)的结果。因此,在较低剂量时,sngfr下降主要是由于LpA降低40%和rpf降低10%;然而,在高剂量时,rps和LpA的大幅降低导致sngfr大幅下降。在补体耗竭的大鼠中,给予相同剂量,低剂量AGBM抗体不再降低sngfr,但LpA的降低仍然存在(其他因素进行代偿以维持sngfr)。在高剂量时,补体耗竭改善了sngfr的降低(从55.1±2.4降至37.2±3.4纳升/分钟/克kw/毫米汞柱),几乎消除了血管收缩,但仅部分减轻了LpA的降低(从0.097±0.020降至0.032±0.004纳升/秒/克kw/毫米汞柱,P<0.05)。补体耗竭阻止了多形核白细胞(高剂量AGBM抗体后数量增多)向毛细血管的迁移并消除了血管收缩。补体耗竭导致高剂量AGBM抗体对LpA的影响比正常大鼠小,这可能是由于多形核白细胞对毛细血管表面积的影响较小。在补体耗竭的大鼠中观察到的LpA持续降低与AGBM抗体作用后内皮细胞与肾小球基底膜分离相关,AGBM抗体通过降低LpA和改变肾小球膜的内皮表面减少了肾小球超滤,并且这种作用并不完全依赖于补体的固定。