Yoshimura A, Ideura T, Shirai M, Taira T, Iwasaki S, Kitaoka T, Koshikawa S
Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
Scand J Urol Nephrol. 1993;27(3):295-9. doi: 10.3109/00365599309180437.
Although the etiology and pathogenesis of progressive renal failure is largely unknown, endotoxin is supposed to be one of the contributory factors. However, the distribution of endotoxin in liver cirrhosis has not been clarified. Therefore we studied the distribution of 3H-labeled endotoxin in the kidney in rats with CCl4-induced liver injury. Daily inhalations of CCl4 on rats for 6 and 10 weeks produced liver fibrosis (LF group, N = 5) and cirrhosis (LC group, N = 5), respectively. At 6 or 10 weeks, animals were sacrificed 24 hours after an intravenous injection of endotoxin labeled with 3H at the galactose moiety (12,000 cpm/1 g body weight). In the liver, 3H-labeled endotoxin was taken up mainly by Kupffer cells as determined by autoradiography. Compared to control rats, in rats of the LC or LF group the measured amount of 3H-labeled endotoxin per gram kidney or ml blood increased, while that of the liver was significantly decreased. A positive correlation of the amount of 3H-labeled endotoxin per weight or volume respectively was shown between kidney and blood, but not between lung or spleen and blood. These results suggest that overflow of endotoxin due to decreased inactivation in the liver causes endotoxemia in liver injury and that the resulting endotoxemia may directly affect the kidney. The resulting endotoxin-induced vasoconstriction may be a contributory factor for the progressive renal failure frequently observed in liver cirrhosis.
虽然进行性肾衰竭的病因和发病机制在很大程度上尚不清楚,但内毒素被认为是促成因素之一。然而,内毒素在肝硬化中的分布尚未明确。因此,我们研究了用四氯化碳诱导肝损伤的大鼠肾脏中3H标记内毒素的分布情况。每天给大鼠吸入四氯化碳,持续6周和10周,分别产生肝纤维化(LF组,N = 5)和肝硬化(LC组,N = 5)。在6周或10周时,给动物静脉注射以半乳糖部分标记的3H内毒素(12,000计数/分钟/1克体重)24小时后将其处死。通过放射自显影法确定,在肝脏中,3H标记的内毒素主要被库普弗细胞摄取。与对照大鼠相比,LC组或LF组大鼠每克肾脏或每毫升血液中3H标记内毒素的测量量增加,而肝脏中的量则显著减少。肾脏与血液之间分别显示出每重量或体积的3H标记内毒素量呈正相关,但肺或脾与血液之间则无此相关性。这些结果表明,肝脏中灭活减少导致内毒素溢出,从而在肝损伤中引起内毒素血症,并且由此产生的内毒素血症可能直接影响肾脏。由此产生的内毒素诱导的血管收缩可能是肝硬化中经常观察到的进行性肾衰竭的一个促成因素。