[Immunodiagnosis of kidney tubular cell injuries using specific anti-membrane antibodies].
In contrast to healthy persons, microvillous antigens of the proximal tubule were excreted at an increased rate in patients with kidney diseases as could be shown using specific antisera against brush border (BB) fragments (tissue-proteinuria, histuria). These urinary membrane components were immunologically completely identical with those antigens prepared from isolated kidney cell membranes. A glycoprotein of 240 000 dalton, containing mannose and N-acetylglucosamine was identified as a major immunoreactive constituent of the brush border surface and found to be part of a multienzyme complex. BB-antigens were excreted in urine of patients with glomerulonephritis, hypertension, pyelonephritis, multiple myeloma, after operations, after kidney transplantation, under cytostatic treatment, and after administration of radiopaque agents. Histuria of BB-antigens was significantly higher in patients with multiple myeloma and Bence-Jones-proteinuria compared to those patients where no Bence-Jones L-chains in urine became apparent. Selective kidney angiography and intravenous urography caused a significantly higher output of BB-antigens as compared to the control period (2 p less than 0,005). In a volunteer model, on the basis of BB-histuria, a different nephrotoxic potency of cephalosporins and aminoglycosides arose. In addition, beside soluble BB-antigens, also high molecular weight membrane vesicles were discovered in urine of patients after cytostatic treatment (cis-platinum), after x-ray contrast media, and after kidney transplantation. Both, soluble as well as supramolecular membrane vesicles were isolated from urine applying immunospecific affinity chromatography (anti-BS-agarose beads). Labeled antisera directed against the vesicle material of urine revealed a specific immunofluorescence of cortical tubule only.(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000954:Antigens, Surface / Q000276:immunology / Q000652:urine; D000970:Antineoplastic Agents / Q000009:adverse effects; D002462:Cell Membrane / Q000276:immunology; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects; D007674:Kidney Diseases / Q000175:diagnosis*; D016030:Kidney Transplantation; D007684:Kidney Tubules / Q000293:injuries; D008297:Male; D008871:Microvilli / Q000276:immunology; D008875:Middle Aged; D010954:Plasmacytoma / Q000276:immunology; D014181:Transplantation Immunology
D000900:Anti-Bacterial Agents; D000954:Antigens, Surface; D000970:Antineoplastic Agents
Immundiagnostik tubulärer Zellschäden der Niere mit Hilfe spezifischer Antimembran-Antikörper.