Umekawa T, Yamate T, Amasaki N, Kurita T
Department of Urology, Kinki University School of Medicine, Osaka, Japan.
Urol Int. 1995;54(3):154-6. doi: 10.1159/000282711.
We previously reported a patient who developed anti-glomerular basement membrane antibody-induced glomerulonephritis (GBM-GN) after extracorporeal shock wave lithotripsy (ESWL). To determine whether ESWL causes anti-GBM antibody production thereby inducing GBM-GN, we measured serum levels of type-IV collagen (the most major component of GBM) before and after ESWL. Serum samples were obtained from 13 patients with renal stones and 15 with ureteral stones. The serum type-IV collagen level was determined by a radioimmunoassay method. No significant changes were observed in the type-IV collagen level after ESWL in each patient group. Type-IV collagen was abundant in the GBM but was not released into the blood after ESWL. Therefore, in patients with urinary tract stones, it is not likely that type-IV collagen, a hidden antigen in the renal glomeruli, is exposed or released into the blood after ESWL, resulting in autoantibody production and GBM-GN.
我们之前报道过一名患者，其在体外冲击波碎石术（ESWL）后发生了抗肾小球基底膜抗体诱导的肾小球肾炎（GBM-GN）。为了确定ESWL是否会导致抗GBM抗体产生从而诱发GBM-GN，我们在ESWL前后测量了血清IV型胶原（GBM的最主要成分）水平。血清样本取自13例肾结石患者和15例输尿管结石患者。血清IV型胶原水平通过放射免疫测定法测定。在每个患者组中，ESWL后IV型胶原水平均未观察到显著变化。IV型胶原在GBM中含量丰富，但ESWL后并未释放到血液中。因此，对于尿路结石患者，肾小球中隐藏的抗原IV型胶原在ESWL后不太可能暴露或释放到血液中，从而导致自身抗体产生和GBM-GN。
