scholarly journals Anti-Gbm Disease in Children: Outcomes and Association with Systemic Vasculitis

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Lung Biopsy ◽  
Systemic Vasculitis ◽  
Case Series ◽  
Autoimmune Disorder ◽  
Basement Membranes ◽  
Dual Positivity ◽  
Relapse Rates

Anti-Glomerular Basement Membrane (anti-GBM) disease is a rare autoimmune disorder affecting the glomerular and alveolar basement membranes. Diagnosis is based on the detection of anti-GBM autoantibodies, along with renal or lung biopsy. Some patients are both anti-GBM and ANCA positive, reflecting an association with systemic vasculitis that has been reported only in some adult cases. Dual positivity of anti-GBM and ANCA is associated with poorer prognosis and higher relapse rates therefore more aggressive and longer treatment is essential. In this case, series we report four cases of children diagnosed with anti-GBM disease that we also screened for signs of systemic vasculitis.

scholarly journals SARS-CoV-2 infection and recurrence of anti-glomerular basement disease: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alexander Winkler ◽  
Emanuel Zitt ◽  
Hannelore Sprenger-Mähr ◽  
Afschin Soleiman ◽  
Manfred Cejna ◽  
...  
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Plasma Cells ◽  
Rapidly Progressive Glomerulonephritis ◽  
Kidney Injury ◽  
Pulmonary Involvement ◽  
Pulmonary Haemorrhage ◽  
Basement Membranes ◽  
High Avidity ◽  
History Of

Abstract Background Anti-glomerular basement membrane disease (GBM) disease is a rare autoimmune disease causing rapidly progressive glomerulonephritis and pulmonary haemorrhage. Recently, an association between COVID-19 and anti-glomerular basement membrane (anti-GBM) disease has been proposed. We report on a patient with recurrence of anti-GBM disease after SARS-CoV-2 infection. Case presentation The 31-year-old woman had a past medical history of anti-GBM disease, first diagnosed 11 years ago, and a first relapse 5 years ago. She was admitted with severe dyspnoea, haemoptysis, pulmonary infiltrates and acute on chronic kidney injury. A SARS-CoV-2 PCR was positive with a high cycle threshold. Anti-GBM autoantibodies were undetectable. A kidney biopsy revealed necrotising crescentic glomerulonephritis with linear deposits of IgG, IgM and C3 along the glomerular basement membrane, confirming a recurrence of anti-GBM disease. She was treated with steroids, plasma exchange and two doses of rituximab. Pulmonary disease resolved, but the patient remained dialysis-dependent. We propose that pulmonary involvement of COVID-19 caused exposure of alveolar basement membranes leading to the production of high avidity autoantibodies by long-lived plasma cells, resulting in severe pulmonary renal syndrome. Conclusion Our case supports the assumption of a possible association between COVID-19 and anti-GBM disease.

Anti-glomerular basement membrane disease: a case series from a single center in Western India

2021 ◽  
Vol 21 (1) ◽  
pp. 31
Author(s):  
Mital Parikh ◽  
Abhijit Konnur ◽  
Umapati Hegde ◽  
Sishir Gang ◽  
Hardik Patel ◽  
...  
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Case Series ◽  
Western India ◽  
Single Center

In vivo biosynthesis and turnover of glomerular basement membrane in diabetic rats

1982 ◽  
Vol 242 (4) ◽  
pp. F385-F389
Author(s):  
M. P. Cohen ◽  
M. L. Surma ◽  
V. Y. Wu
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Diabetic Rats ◽  
Basement Membranes ◽  
Membrane Turnover ◽  
Proline Incorporation ◽  
Basement Membrane Collagen ◽  
Osmotic Lysis ◽  
Specific Activities

Glomerular basement membrane (GBM) was labeled in vivo by the injection of tracer amounts of tritiated proline into normal and streptozotocin-diabetic rats. Basement membrane biosynthesis and turnover were determined from the specific activities of proline and hydroxyproline in samples purified following osmotic lysis of glomeruli isolated 4 h to 12 days after injection. Peak radiolabeling of normal and diabetic GBM occurred within 24-48 h and 48-72 h, respectively, and, when corrected for differences in the serum proline specific activities, [3H]proline incorporation was greater in diabetic than in normal samples. In contrast to the subsequent time-dependent progressive decline in radiolabeling in basement membranes from normal animals, specific activities of proline and hydroxyproline in diabetic glomerular basement membrane did not change significantly over the same period of observation. Renal cortical mass and glomerular basement membrane collagen content were preserved in diabetic animals despite loss of body weight. The findings are compatible with prolongation of glomerular basement membrane turnover in experimental diabetes, and suggest that diminished degradation contributes to the accumulation of glomerular basement membrane that is characteristic of chronic diabetes.

scholarly journals Anionic charge concentration of rat kidney glomeruli and glomerular basement membrane

1993 ◽  
Vol 289 (3) ◽  
pp. 647-652 ◽  
Author(s):  
W D Comper ◽  
A S N Lee ◽  
M Tay ◽  
Y Adal
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Electrostatic Interactions ◽  
Enzyme Inhibitors ◽  
Rat Kidney ◽  
Basement Membranes ◽  
Sulphate Content ◽  
Anionic Charge ◽  
Charge Concentration ◽  
A Charge

Estimates of levels of glomerular and glomerular-basement-membrane anion charge should serve as useful quantitative markers for the integrity of the tissues in health and disease. We have developed a simple, rapid, technique to measure this charge through the use of ion exchange with radioisotopes 22Na+ and 36Cl- at low ionic strengths in phosphate buffer. When this technique is used, normal glomeruli isolated from rat have a measured net anion charge concentration of 17.4 +/- 3.7 p-equiv. per glomerulus (n = 20). Perfused rat kidneys that lose approximately half of their glomerular heparan [35S]sulphate content (owing to oxygen-radical damage) exhibited a lower anion charge, of 7.5 +/- 1.6 p-equiv. per glomerulus (n = 5). Glomerular basement membranes prepared from rat glomeruli by a sonication-centrifugation procedure in the presence of enzyme inhibitors had a charge concentration of 6.3 +/- 0.7 mu-equiv./g wet wt. of tissue (n = 4), whereas membranes prepared by sonication, centrifugation, DNAse and detergent treatment had a charge concentration of 7.1 +/- 1.6 mu-equiv./g wet wt. (n = 4). Isotope-dilution experiments with 3H2O on these detergent-prepared glomerular basement membranes demonstrated that they had a water content of approx. 93%, which would then give a net anion charge concentration of 7.6 +/- 1.7 m-equiv./l (n = 4). These values are in good agreement with those obtained by others using titration techniques [Bray and Robinson (1984) Kidney Int. 25, 527-533]. The relatively low magnitude of glomerular anion charge in normal kidneys is consistent with other recent findings that glomerular anion charge is too low to affect the glomerular transport of charged molecules in a direct, passive, biophysical manner through electrostatic interactions.

scholarly journals Mesangial cells organize the glomerular capillaries by adhering to the G domain of laminin α5 in the glomerular basement membrane

2003 ◽  
Vol 161 (1) ◽  
pp. 187-196 ◽  
Author(s):  
Yamato Kikkawa ◽  
Ismo Virtanen ◽  
Jeffrey H. Miner
Keyword(s):  
Cell Adhesion ◽  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Mesangial Cell ◽  
Mesangial Cells ◽  
Basement Membranes ◽  
Domain Specific ◽  
Integrin Α3β1 ◽  
Glomerular Capillaries

In developing glomeruli, laminin α5 replaces laminin α1 in the glomerular basement membrane (GBM) at the capillary loop stage, a transition required for glomerulogenesis. To investigate domain-specific functions of laminin α5 during glomerulogenesis, we produced transgenic mice that express a chimeric laminin composed of laminin α5 domains VI through I fused to the human laminin α1 globular (G) domain, designated Mr51. Transgene-derived protein accumulated in many basement membranes, including the developing GBM. When bred onto the Lama5 −/− background, Mr51 supported GBM formation, preventing the breakdown that normally occurs in Lama5 −/− glomeruli. In addition, podocytes exhibited their typical arrangement in a single cell layer epithelium adjacent to the GBM, but convolution of glomerular capillaries did not occur. Instead, capillaries were distended and exhibited a ballooned appearance, a phenotype similar to that observed in the total absence of mesangial cells. However, here the phenotype could be attributed to the lack of mesangial cell adhesion to the GBM, suggesting that the G domain of laminin α5 is essential for this adhesion. Analysis of an additional chimeric transgene allowed us to narrow the region of the α5 G domain essential for mesangial cell adhesion to α5LG3-5. Finally, in vitro studies showed that integrin α3β1 and the Lutheran glycoprotein mediate adhesion of mesangial cells to laminin α5. Our results elucidate a mechanism whereby mesangial cells organize the glomerular capillaries by adhering to the G domain of laminin α5 in the GBM.

scholarly journals Anti-glomerular basement membrane disease: Case series from a tertiary center in North India

2017 ◽  
Vol 27 (2) ◽  
pp. 108
Author(s):  
M Rathi ◽  
D Prabhakar ◽  
R Nada ◽  
RW Minz ◽  
V Kumar ◽  
...  
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Case Series ◽  
North India ◽  
Disease Case ◽  
Tertiary Center

scholarly journals Agrin Is a Major Heparan Sulfate Proteoglycan in the Human Glomerular Basement Membrane

1998 ◽  
Vol 46 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Alexander J. Groffen ◽  
Markus A. Ruegg ◽  
Henri Dijkman ◽  
Thea J. van de Velden ◽  
Carin A. Buskens ◽  
...  
Keyword(s):  
Basement Membrane ◽  
Heparan Sulfate ◽  
Glomerular Basement Membrane ◽  
Heparan Sulfate Proteoglycan ◽  
Basement Membranes ◽  
Sulfate Proteoglycan ◽  
Linear Distribution ◽  
Cell Matrix ◽  
Sds Page ◽  
Strong Staining

Agrin is a heparan sulfate proteoglycan (HSPG) that is highly concentrated in the synaptic basal lamina at the neuromuscular junction (NMJ). Agrin-like immunoreactiv-ity is also detected outside the NMJ. Here we show that agrin is a major HSPG component of the human glomerular basement membrane (GBM). This is in addition to perlecan, a previously characterized HSPG of basement membranes. Antibodies against agrin and against an unidentified GBM HSPG produced a strong staining of the GBM and the NMJ, different from that observed with anti-perlecan antibodies. In addition, anti-agrin antisera recognized purified GBM HSPG and competed with an anti-GBM HSPG monoclonal antibody in ELISA. Furthermore, both antibodies recognized a molecule that migrated in SDS-PAGE as a smear and had a molecular mass of approximately 200–210 kD after deglycosylation. In immunoelectron microscopy, agrin showed a linear distribution along the GBM and was present throughout the width of the GBM. This was again different from perlecan, which was exclusively present on the endothelial side of the GBM and was distributed in a nonlinear manner. Quantitative ELISA showed that, compared with perlecan, the agrin-like GBM HSPG showed a sixfold higher molarity in crude glomerular extract. These results show that agrin is a major component of the GBM, indicating that it may play a role in renal ultrafiltration and cell matrix interaction.

scholarly journals Loss of laminin epitopes during glomerular basement membrane assembly in developing mouse kidneys.

1992 ◽  
Vol 40 (12) ◽  
pp. 1943-1953 ◽  
Author(s):  
D R Abrahamson ◽  
P L St John
Keyword(s):  
Endothelial Cells ◽  
Basement Membrane ◽  
Horseradish Peroxidase ◽  
Glomerular Basement Membrane ◽  
Basement Membranes ◽  
Proteolytic Processing ◽  
Newborn Mouse ◽  
Capillary Loop ◽  
Loop Expansion ◽  
Initial Assembly

Kidney glomerular basement membranes (GMBs) originate in development from fusion of a dual basement membrane between endothelial cells and primitive epithelial podocytes. After fusion, segments of newly synthesized matrix, derived primarily from podocytes, appear as subepithelial outpockets and are spliced into GBMs during glomerular capillary loop expansion. To investigate GBM assembly further, we examined newborn mouse kidneys with monoclonal rat anti-mouse laminin IgGs (MAb) conjugated to horseradish peroxidase (HRP). In adults, these MAb strongly label glomerular mesangial matrices but bind only weakly or not at all to mature GBMs. In contrast, anti-laminin MAb intensely bound newborn mouse GBMs undergoing initial assembly. After intraperitoneal injection of MAb-HRP into neonates, dense binding occurred across both subendothelial and subepithelial pre-fusion GMBs as well as forming mesangial matrices. Considerably less MAb binding was seen, however, in post-fusion GBMs from more mature glomeruli in the same section, although mesangial matrices remained positive. In addition, new subepithelial segments in areas of splicing were negative. These results conflict with those obtained previously with injections of polyclonal anti-laminin IgGs into newborns or adults, which result in complete labeling of all GBMs. Although epitope masking cannot be completely excluded, we believe that decreased MAb binding to developing GBM reflects actual epitope loss. This loss could occur by laminin isoform substitution, conformational change, and/or proteolytic processing during GBM assembly.

scholarly journals Renal glomerular proteoglycans. An investigation of their synthesis in vivo using a technique for fixation in situ

1988 ◽  
Vol 251 (2) ◽  
pp. 411-418 ◽  
Author(s):  
L A Beavan ◽  
M Davies ◽  
R M Mason
Keyword(s):  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Membrane Fraction ◽  
Chondroitin Sulphate ◽  
Heparan Sulphate ◽  
Basement Membranes ◽  
Chondroitin Sulphate Proteoglycans

Newly synthesized rat glomerular [35S]proteoglycans were labelled in vivo after injecting Na2[35S]SO4 intraperitoneally. At the end of the labelling period (7 h) the kidneys were perfused in situ with 0.01% (w/v) cetylpyridinium chloride. This fixed proteoglycans in the tissue and increased their recovery 2-3-fold during subsequent isolation of glomeruli from the renal cortex. The glomeruli were fractionated by a modified osmotic lysis and detergent extraction procedure [Meezan, Brendel, Hjelle & Carlson (1978) in The Biology and Chemistry of Basement Membranes (Kefalides, N.A., ed.), Academic Press, New York; Kanwar & Farquhar (1979) Proc. Natl. Acad. Sci. U.S.A. 76, 4493-4497] to obtain a basement membrane preparation. The proteoglycans released at each stage of the procedure were characterized using DEAE-Sephacel ion-exchange chromatography, chondroitinase ABC and HNO2 digestion and Sepharose CL-4B gel-permeation chromatography. About 85% of the [35S]proteoglycans synthesized were of the heparan sulphate variety, the remainder being chondroitin sulphate proteoglycans. Three sizes of heparan sulphate proteoglycans were identified. The largest (HS1, Kav. 0.47) accounts for 44% of the total extractable heparan sulphates. About one third of HS1 were extracted from the glomerular basement-membrane fraction with 8 M-urea and 4 M-guanidine hydrochloride but the remainder were released from the glomerulus during preparation of the fraction. The two smaller molecules (HS2, Kav. 0.56 and HS3, Kav. 0.68) accounted for 27% and 28% of the extractable heparan sulphate respectively and were not associated with the basement membrane fraction. HS1, HS2 and HS3 were also isolated from non-fixed glomeruli labelled in vivo but with much lower recovery. In glomeruli labelled in vitro, heparan sulphate accounted for only 35% of the proteoglycans, the remainder being of the chondroitin sulphate type. Proteoglycans similar to HS1, HS2 and HS3 were present in glomeruli labelled in vitro but, in addition, a large, highly charged heparan sulphate (HS1a) was extracted from the glomerular basement-membrane fraction of these glomeruli. It accounted for 6% of the total heparan sulphate.

scholarly journals Lipids associated with bovine kidney glomerular basement membranes

1976 ◽  
Vol 155 (3) ◽  
pp. 535-541 ◽  
Author(s):  
G Kibel ◽  
A Heilhecker ◽  
F Von Bruchhausen
Keyword(s):  
Fatty Acids ◽  
Basement Membrane ◽  
Lipid Content ◽  
Glomerular Basement Membrane ◽  
Membrane Lipids ◽  
Neutral Lipids ◽  
Methyl Esters ◽  
Specific Radioactivity ◽  
Basement Membranes ◽  
Total Lipid Extract

1. After incubation of bovine glomeruli with D-[U-14C]glucose, about 21% of the total radioactivity is found in lipid extracts of glomerular basement membranes. 2. The concentration of lipids in glomerular basement membranes (4.3% of dry wt.) is lower than in the residual glomerular particles (10.8% of dry wt.). The concentrations of neutral lipids (13.9%), phospholipids (46.7%) and cholesterol (37.9%) in the total lipid extract of the glomerular basement membranes, however, differ from those in the residual glomerular particles (15.6, 54.0 and 30.9% respectively). Though residual glomerular particles show a higher lipid content, the radioactivity in this fraction only amounts to 38% of that found in the glomerular basement membranes. 3. The specific radioactivity of total glomerular basement-membrane lipids (12 600 d.p.m./mg) is about 4 times as high as that of the glomerular basement membranes. The specific radioactivities of the individual lipid components, however, differ. The highest values are found for phosphatidylcholine and triacylglycerols. The largest proportion of the radioactivity is found in the glycerol of the glycerides. The radioactivity in the fatty acids is much less and does not differ significantly in the various classes of lipids. 4. G.1.c. of methyl esters of the fatty acids does not reveal a clear difference between the fatty acid compositions of glomerular basement membranes and residual glomerular particles. 5. Treatment of glomerular basement-membrane preparations with ultrasound, the generally used procedure for glomerular basement-membrane preparations, drastically decreases the lipid content of glomerular basement membranes. 6. It is concluded that lipids are associated with the basement membranes. Further, the comparatively high radioactive labelling suggests that glomerular basement-membrane lipids may be an interesting class of substances for further pathological studies.

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