Dávila de Arriaga A J, Rocha A S, Yasuda P H, De Brito T
J Pathol. 1982 Oct;138(2):145-61. doi: 10.1002/path.1711380205.
Thirty-seven guinea-pigs experimentally infected with a virulent strain of L. icterohaemorrhagiae, were submitted to a renal function study as evaluated through the maximal urinary concentration (MUC) test, blood urea nitrogen (BUN) and afterwards had their kidneys examined by light and electron microscopy. Vascular changes were also studied after the administration of colloidal carbon as a marker. Through the MUC test and BUN determination, two groups of tubulo-interstitial lesions can be visualised, one in animals without renal sufficiency, manifested chiefly by cell edema with RE dilation and another, in animals with renal insufficiency, characterised not only by marked cell edema and mitochondrial changes, but also by proximal tubule regenerative aspects without overt tubular necrosis. Interstitial edema and focal nephritis was prominent in both groups, a finding which minimises their role in the pathogenesis of renal failure in experimental leptospirosis. Vascular injury, affecting the vessels of the renal microcirculation chiefly at the cortico-medular junction, was observed in both groups. Its severity and extension ran parallel to the intensity of the tubular injury. This suggests a simultaneous action of a noxious agent liberated by the leptospires over both structures, tubular damage being accentuated by the local circulatory changes.
37只经强毒株出血性黄疸钩端螺旋体实验感染的豚鼠,通过最大尿浓缩(MUC)试验、血尿素氮(BUN)进行肾功能研究,之后对其肾脏进行光镜和电镜检查。还在给予胶体碳作为标记物后研究血管变化。通过MUC试验和BUN测定,可以观察到两组肾小管间质病变,一组在无肾功能不全的动物中,主要表现为细胞水肿伴内质网扩张;另一组在有肾功能不全的动物中,不仅表现为明显的细胞水肿和线粒体变化,还表现为近端小管再生现象而无明显的肾小管坏死。两组间质水肿和局灶性肾炎均很突出,这一发现降低了它们在实验性钩端螺旋体病肾衰竭发病机制中的作用。两组均观察到血管损伤,主要影响肾微循环位于皮质 - 髓质交界处的血管。其严重程度和范围与肾小管损伤的强度平行。这表明钩端螺旋体释放的有毒物质对这两种结构同时起作用,局部循环变化加剧了肾小管损伤。