Blantz R C, Gabbai F B, Peterson O, Wilson C B, Kihara I, Kawachi H, Shimizu F, Yamamoto T
Department of Medicine, University of California, San Diego School of Medicine.
J Am Soc Nephrol. 1994 Jun;4(12):1957-64. doi: 10.1681/ASN.V4121957.
The glomerular barriers to water and macromolecular movement were examined 2 and 24 h after the administration of a monoclonal antibody (mAb) specific to an antigen located on the epithelial slit diaphragm and the external aspect of the glomerular basement membrane. By micropuncture techniques 2 h after mAb administration, single-nephron GFR (SNGFR) and plasma flow were unchanged but the glomerular capillary hydrostatic pressure gradient and glomerular capillary hydrostatic pressure were increased and the glomerular ultrafiltration coefficient (LpA) decreased to values that were 50% of the normal control. There was no increase in urinary protein excretion at 2 h. However, at 24 h after mAb, nephron plasma flow (SNPF) and SNGFR increased and the glomerular ultrafiltration coefficient returned to values indistinguishable from the normal control. At 24 h, there was a marked increase in protein excretion. The administration of meclofenamate decreased values for SNGFR and SNPF to normal. Immunoglobulin G was exclusively bound to glomerular capillary walls in a linear or continuous fashion at 2 h, but in a discontinuous, granular pattern at 24 h. These studies suggest that after mAb, important limiting glomerular barriers for hydraulic conductivity and protein excretion reside on the epithelial aspect of the glomerular capillary basement membrane, specifically at the level of the slit diaphragm. Studies also suggest that alterations in glomerular capillary hydraulic conductivity can be effectively separated from increases in macromolecular permeability.
在给予一种针对位于上皮细胞裂孔隔膜和肾小球基底膜外侧的抗原的单克隆抗体(mAb)后2小时和24小时,检测了肾小球对水和大分子物质移动的屏障。通过微穿刺技术,在给予mAb后2小时,单肾单位肾小球滤过率(SNGFR)和血浆流量未改变,但肾小球毛细血管静水压梯度和肾小球毛细血管静水压增加,而肾小球超滤系数(LpA)降至正常对照值的50%。2小时时尿蛋白排泄未增加。然而,在给予mAb后24小时,肾单位血浆流量(SNPF)和SNGFR增加,肾小球超滤系数恢复到与正常对照无差异的值。24小时时,蛋白排泄显著增加。给予甲氯芬那酸使SNGFR和SNPF值降至正常。免疫球蛋白G在2小时时以线性或连续方式仅结合于肾小球毛细血管壁,但在24小时时呈不连续的颗粒状模式。这些研究表明,给予mAb后,对水导率和蛋白排泄起重要限制作用的肾小球屏障位于肾小球毛细血管基底膜的上皮侧,特别是在裂孔隔膜水平。研究还表明,肾小球毛细血管水导率的改变可与大分子通透性的增加有效分离。