糸球体腎炎の発症と進展に関する研究

―糸球体腎炎の経過におよぼす乏血因子の影響―

抄録

To study the effect of renal ischemia on the progression of glomerulonephritis experimentally, Masuginephritis was induced in rabbits and four weeks later the left renal artery of each animal was constricted. Alteration of the kidneys were perused with biopsy- and autopsy-specimens up to twenty weeks after the clamp. Histologically, glomerular alterations could be deviled into five types (A-E) ; (A) of normal appearance, (B) with exudation and proliferation, (C) with ischemic alterations alone, (D) showing both proliferation and ischemia with capillary and capsular contact and (E) of hyalinization. In the constricted kidneys, the number of (A) was significantly less than the other side. There was a tendency to be " the longer the constricted duration, the more decreased the ratio of (A)". And (E) began to appear in four weeks after the operation, the rate of occurrence reaching 1.5-3 times of non-constricted sides, and the rate of (B) began to decrease from 8 th week after the operation. Different from non-clipped side, (C) developed early after the operation and increased to about 30% of total glomeruli, as well as (D), the maximal rate of which reached to 24% in 10 th weeks, gradually decreasing thereafter. (D) is characteristically found in the kidneys with severe ischemia and glomerular inflammatory changes and some of them, at least, are assumed to progress into hyalinization. Thus, renal' ischemia seems to accelerate the deterioration of the glomerular inflammatory lesions. Electron microscopic observation of (C) revealed prominent wrinkling of the capillary basement membrane and decreasing of mesangial matrix. By immunofluorescent studies, the brightness of capillary pattern of the glomeruli of the clipped kidneys was almost identical or less intensive than those of the non-clipped kidneys. These results suggest no participation of additional immune-mechanism in the deterioration of the glomerular changes. Though J-G indices in these glomeruli were variable, the indices of non-clipped were often larger than those of clipped kidneys.