肝素在慢性氨基核苷肾病中的非抗凝保护作用。

Renal physiology Pub Date : 1986-01-01 DOI:10.1159/000173102
J R Diamond, M J Karnovsky
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引用次数: 57

摘要

氨基核苷肾病在18周内发展为局灶性和节段性肾小球硬化(FSGS)。在另一种FSGS模型肾消融中,全肝素已被证明可以减轻肾损伤的程度;然而,保护的确切机制仍然不确定。由于肝素具有多种与抗凝无关的生理作用,我们对给予单次静脉注射嘌呤霉素氨基核苷(PA)的大鼠组给予三种不同的肝素化合物,每种化合物具有不同的生物学特性。在没有延长的活化部分凝血活素时间(aPTT),全肝素(WH)和7000 - 11000道尔顿分子量的非抗凝肝素(NAH)改善了慢性氨基核苷肾病的功能和组织学异常,在研究结束时,与未经治疗的PA对照动物相比,24小时尿蛋白排泄量显著减少,同时保持肾小球滤过率并减弱血清肌酐的升高。此外,给药18周后,NAH组和WH组肾小球系膜节段性增生区或肾小球硬化/透明质病变明显减少。一小段肝素(HF)无效。我们得出结论,肝素在慢性氨基核苷肾病中可能通过一种生物作用发挥其有益作用,而不是抗凝,可能是通过抑制系膜细胞增殖。
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Nonanticoagulant protective effect of heparin in chronic aminonucleoside nephrosis.

Aminonucleoside nephrosis progresses over an 18-week period to focal and segmental glomerulosclerosis (FSGS). Whole heparin has been shown to blunt the extent of renal injury in another model of FSGS, renal ablation; however, the precise mechanism of protection has remained uncertain. Since heparin has a variety of physiologic actions unrelated to anticoagulation, we administered three different heparin compounds, each with a distinct profile of biological properties, to groups of rats given a single intravenous dose of puromycin aminonucleoside (PA). In the absence of a prolongation of the activated partial thromboplastin time (aPTT), both whole heparin (WH) and a 7,000- to 11,000-dalton-molecular-weight nonanticoagulant heparin (NAH) ameliorated the functional and histologic abnormalities of chronic aminonucleoside nephrosis as evidenced by significant reductions in 24-hour urine protein excretion while preserving the glomerular filtration rate and blunting the rise in serum creatinine as compared to untreated PA control animals at the conclusion of the study. In addition, the NAH and WH groups exhibited significantly fewer glomeruli with either segmental mesangial proliferative areas or glomerulosclerosis/hyalinosis lesions 18 weeks after PA administration. A fragment of heparin (HF) was ineffective. We conclude that heparin may exert its beneficial effect in chronic aminonucleoside nephrosis through a biologic action, other than anticoagulation, perhaps by inhibition of mesangial cell proliferation.

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