Cohen A H
Lab Invest. 1981 Mar;44(3):280-7.
The structure of renal tubular hyaline casts in kidney biopsies from patients with the nephrotic syndrome was studied and defined by light, immunofluorescence, and electron microscopies. Two distinct types of casts were identified. One, intensely stained with periodic acid-Schiff's reagent, was formed almost exclusively of myriads of fine, hollow tubular fibrils of indefinite length and approximately 40 Angstroms in width. The other, of slight periodic acid-Schiff positivity, was made up chiefly of a finely granular, medium dense matrix, often, however, with similar filaments as above but in considerably lesser quantities, as well as numerous remnants of degenerating cytoplasm. The fibrillar matrix of both of these casts is clearly Tamm-Horsfall protein, previously demonstrated to have identical fine structural features when studied as filaments isolated from urine. Furthermore, with the use of specific fluoresceinated antiserum, most casts were shown to consist of Tamm-Horsfall protein. The filaments comprising the casts may be confused with amyloid because of ultrastructural similarities, especially when observed in urinary sediments.
对肾病综合征患者肾活检中肾小管透明管型的结构进行了研究，并通过光学显微镜、免疫荧光显微镜和电子显微镜进行了界定。鉴定出两种不同类型的管型。一种用高碘酸-希夫试剂染色强烈，几乎完全由无数细小、中空、长度不定且宽度约为40埃的管状纤维组成。另一种高碘酸-希夫反应呈弱阳性，主要由细颗粒状、中等密度的基质组成，但通常也有与上述相似的细丝，不过数量要少得多，还有许多退化细胞质的残余物。这两种管型的纤维状基质显然都是Tamm-Horsfall蛋白，以前从尿液中分离出的细丝进行研究时，已证明其具有相同的精细结构特征。此外，使用特异性荧光抗血清显示，大多数管型由Tamm-Horsfall蛋白组成。由于超微结构相似，组成管型的细丝可能会与淀粉样蛋白混淆，尤其是在尿沉渣中观察时。
