Schlottmann K, Gulbins E, Rauterberg E W, Steinhausen M
Department of Physiology, University of Heidelberg, Germany.
Eur J Clin Invest. 1994 May;24(5):320-30. doi: 10.1111/j.1365-2362.1994.tb01092.x.
In a variety of immunopathological diseases activation of the complement cascade occurs either systemically or localized in the kidney. To elucidate the functional impact of complement activation upon the renal microcirculation, we administered cobra venom factor of Naja naja kaouthia (CVF) i.v. into thiobarbital anaesthetized female rats. CVF is a potent activator of the alternative pathway of complement by forming the C3-convertase CVF, Bb which cannot be downregulated by the natural inhibitor factors H and I and thereby leads to generation of the anaphylatoxins C3a and C5a and formation of the membrane attack complex (MAC). We utilized creatinine clearance and flowmeter measurements in the normal kidney and intravital microscopy of the split hydronephrotic rat kidney model to observe the microvascular changes. Bolus injection of CVF (100 U kg-1) resulted in an immediate reduction of RBF (-68% after 10 min), which remained decreased during the entire experiment (90 min). Systemic blood pressure was significantly reduced only in the early period (-23% of control: 126 mmHg after 10 min). After an initial anuric phase of 30 min duration, the glomerular filtration rate was significantly diminished by 47%. White cell count was decreased by about 50% after the experiments. Application of the competitive thromboxane A2-antagonist, BM 13505, reversed all renal and systemic CVF-effects. Continuous infusion of the competitive leukotriene D4-antagonist, ICI 198615, attenuated the late renal CVF-effects (i.e. 30 min after injection of CVF). Depletion of polymorphonuclear cells (PMN) attenuated the CVF-effects similar to BM 13505. Intravenous administration of CVF in the hydronephrotic kidney model resulted in a massive constriction of the interlobar and arcuate artery, with a fall in glomerular blood flow comparable to the reduction of RBF in the normal kidney. Diameters of the afferent arterioles--most sensitive to many vasoconstricting agents--were not significantly altered. Our results suggest that injection of CVF and the liberation of high amounts of the anaphylatoxins, C3a and C5a, induces the release of TXA2, which contributes to the early renal effects and the formation of cysteinyl-leukotrienes which play an important role in the late phase of systemic complement activation. Utilizing the split hydronephrotic kidney model we demonstrated the predominant action of complement activation on the large preglomerular vessels for the first time. PMN are seemingly involved in the liberation of secondary mediators which appear to reduce renal blood flow and glomerular filtration.
在多种免疫病理疾病中,补体级联反应的激活可发生于全身或局限于肾脏。为阐明补体激活对肾脏微循环的功能影响,我们将眼镜蛇毒因子(CVF)静脉注射到硫喷妥钠麻醉的雌性大鼠体内。CVF是补体替代途径的强效激活剂,通过形成C3转化酶CVF、Bb来激活补体替代途径,该转化酶不能被天然抑制因子H和I下调,从而导致过敏毒素C3a和C5a的产生以及膜攻击复合物(MAC)的形成。我们利用正常肾脏的肌酐清除率和流量计测量以及肾积水大鼠肾脏模型的活体显微镜观察来检测微血管变化。静脉推注CVF(100 U/kg)导致肾血流量立即减少(10分钟后减少68%),在整个实验过程(90分钟)中一直保持降低。仅在早期全身血压显著降低(降至对照值的23%:10分钟后为126 mmHg)。在持续30分钟的初始无尿期后,肾小球滤过率显著降低47%。实验后白细胞计数减少约50%。应用竞争性血栓素A2拮抗剂BM 13505可逆转所有肾脏和全身的CVF效应。持续输注竞争性白三烯D4拮抗剂ICI 198615可减轻CVF对肾脏的后期效应(即注射CVF后30分钟)。多形核白细胞(PMN)的耗竭减轻CVF效应的程度与BM 13505相似。在肾积水肾脏模型中静脉注射CVF导致叶间动脉和弓状动脉大量收缩,肾小球血流量下降程度与正常肾脏肾血流量的减少程度相当。对许多血管收缩剂最敏感的入球小动脉直径未发生显著改变。我们的结果表明,注射CVF以及大量过敏毒素C3a和C5a的释放会诱导血栓素A2的释放,这导致了早期肾脏效应,以及半胱氨酰白三烯的形成,后者在全身补体激活的后期起重要作用。利用肾积水肾脏模型,我们首次证明了补体激活对肾小球前大血管的主要作用。PMN似乎参与了次级介质的释放,这些介质似乎会减少肾血流量和肾小球滤过率。