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Department
of Pediatrics at the Children\'s Hospital of Philadelphia (JRH, CHT, MMD)
and University of Pennsylvania School of Medicine (JRH), Philadelphia, Pennsylvania;
and Department of Pathology (ABF), Vanderbilt University School of Medicine,
Nashville, Tennessee
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Heterogeneity of structure and function among nephrons is a well-recognized
feature of chronic renal diseases. However, only a small number of superficial
nephrons per kidney are accessible for micropuncture analysis and relationships
of proteinuria to structural change in individual nephrons of experimental
models are not clearly established. To directly evaluate proteinuria in
many individual nephrons, we developed an immunomorphometric method of
analysis. This method is based on the uniformly abundant renal synthesis
of Tamm-Horsfall protein (THP) in the thick ascending limb of Henle\'s
loop (TAL). Luminal rabbit immunoglobulin G (IgG) deposits are formed
in TALs of proteinuric nephrons in rats injected with heterologous IgG
anti-THP antibodies. This immunomorphometric luminal deposit method of
assessing proteinuria was previously validated through analysis of heterologous
immune complex nephropathy. Glomerular dysfunction in several models -
spontaneously hypertensive rats (SHR), aging Sprague-Dawley (SD) rats,
rats with adriamycin nephropathy (ADR), and rats subjected to subtotal
nephrectomy (NX) - was characterized by immunomorphometric analysis after
injection of anti-THP antibodies. Luminal IgG deposits were used to identify
nephrons with increased proteinuria. Nephrons were identified histologically
as either long looped (LL) or short looped (SL), and frequency of luminal
deposits in these nephrons was determined. Glomerular size and sclerosis
in deep and superficial zones of renal cortex were determined. Luminal
deposits in LL nephrons were more frequent than luminal deposits in SL
nephrons in SHRs (p < .001) and aging rats (p < .001) and SL nephrons
in ADR rats (p < .02). Whole kidney levels of albuminuria correlated
closely with the frequency of luminal deposits in both LL and SL nephrons
of SHRs and ADR rats and in LL nephrons of aging rats (p < .005). In
contrast, LL and SL deposits were equal in NX rats and did not correlate
with albuminuria. A majority of luminal deposits extended beyond the first
medullary TAL zone of NX rats, but was confined to this zone in the other
3 models. Deep cortical glomeruli were larger with more glomerulosclerosis
than superficial cortical glomeruli. Albuminuria correlated with sclerosis
of both deep (p < .002) and superficial (p < .01) glomeruli in NX
rats, but not in the other three models. These studies provide a detailed
characterization of a new method that allows comparison of proteinuria
derived from deep and superficial nephrons. They also provide evidence
that pathogenesis of the glomerulosclerosis in NX rats differs from that
of the other three models. Glomerulosclerosis was closely linked to the
overall level of albuminuria in NX rats, but not to luminal deposits.
In the other three models, albuminuria and luminal deposits were closely
linked but did not correlate with glomerulosclerosis. Furthermore, LL
and SL nephron proteinuria of NX rats was comparable while LL proteinuria
was markedly greater than SL proteinuria in the other three models. The
luminal deposit method provides a new way to analyze heterogeneity of
proteinuria among nephrons and the mechanisms underlying structural change
in experimental glomerular diseases.
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