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Podocyte Bridges Between the Tuft and Bowman's Capsule

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Podocyte Bridges Between the Tuft and Bowman's Capsule J Am Soc Nephrol 12: 2060–2071, 2001 Podocyte Bridges between the Tuft and Bowman’s Capsule: An Early Event in Experimental Crescentic Glomerulonephritis MICHEL LE HIR,* CORNELIA KELLER,* VALE´ RIE ESCHMANN,* BRUNHILDE HA¨ HNEL,† HILTRAUDE HOSSER,† and WILHELM KRIZ† *Institute of Anatomy, University of Zurich, Switzerland; and †Institute of Anatomy, University of Heidelberg, Germany. Abstract. Although experimental crescentic glomerulonephritis and prominent microvillous transformation, and some cres- starts with an endocapillary inflammation, the crescents them- cents were found. On day 10, crescents were found in 40% of selves seem to originate from the proliferation of parietal glomeruli. The most surprising finding was podocytes that epithelial cells (PEC). In this study, an attempt was made to adhered to both the glomerular basement membrane and the disclose a link between the two processes by a morphologic parietal basement membrane, thus forming bridges between the analysis of early stages of the disease. Mice were immunized tuft and Bowman’s capsule. Those podocyte bridges were with rabbit IgG in complete Freund’s adjuvant on day Ϫ6. At sparse on day 3 but were regularly encountered on days 6 and day 0, they received an intravenous injection of a rabbit anti- 10 in glomeruli without crescents and also as a component of glomerular basement membrane serum. On days 3, 6, and 10, crescents. They were interposed between PEC and later be- the kidneys were fixed by vascular perfusion for examination tween the cells of a crescent without formation of junctional by light and electron microscopy. On day 3, morphologic connection with these cells. It is proposed that the spreading of alterations affected mainly the endocapillary compartment; podocytes on the parietal basement membrane represents a most podocytes appeared to be intact. On day 6, alterations of lesion of the parietal epithelium and that this process initiates podocytes were widespread, including foot process effacement the proliferation of PEC to form a crescent. A cellular crescent consists of a multilayered accumulation of the disease. Indeed, Boucher and colleagues (5) found a pre- cells that limit a diseased glomerulus in the place of the simple dominance of PEC in crescents in patients who showed an epithelium of Bowman‘s capsule. Concepts about the cellular intact parietal basement membrane (PBM). In contrast, mac- composition of crescents have evolved along with the available rophages were the major cell population of crescents in patients techniques. Three periods may be identified, of which the two in which ruptures of the PBM were detected, which possibly first have been reviewed by Jennette and Hipp (1). In early represents a later stage of disease (5). In contrast to clinical studies, it was postulated on the basis of structural studies that studies, animal models of anti–glomerular basement mem- crescents originated from the proliferation of epithelial cells. In brane (GBM) glomerulonephritis offer the possibility to ana- a second period, as antibodies against leukocytes became lyze the first days of crescent formation. In rats, crescents broadly available, many studies demonstrated the presence of consisted of epithelial cells as long as the PBM was intact (7). macrophages in crescents, and this cell type was for many Rupture of the PBM initiated a fibrocellular organization of years the focus of interest. In a third period, it became possible crescents, with a high incidence of macrophages (7). In rabbits, to identify parietal epithelial cells (PEC) by use of antibodies macrophages were rare in crescents, in spite of their abundance against cytokeratin (1–4) or other antigens (5,6). It then be- in the endocapillary compartment (8). In mice, the model used came evident that, in most patients, PEC are the predominant in this study, crescents were composed of PEC, whereas mac- cell type in crescents. The fact that, in some patients, PEC rophages were lacking (6). Increased proliferation of parietal represented only a small proportion of cells in crescents does epithelial cells has been measured in anti-GBM glomerulone- not necessarily reflect a heterogeneous origin of crescents. phritis in the three species (8–11). Rather, the cellular composition changes with the evolution of The events that trigger the proliferation of PEC in crescentic glomerulonephritis remain obscure. PEC are not in direct con- tact with the endocapillary compartment in which the inflam- Received November 6, 2000. Accepted April 12, 2001. matory process is initiated. Furthermore, it is not known how Correspondence to Michel Le Hir, Institute of Anatomy, University of Zu¨rich, the simple squamous parietal epithelium acquires the specific 8057 Zu¨rich, Switzerland. Phone: ϩ41 1 635 53 16; Fax: ϩ41 1 635 57 02; E-mail: [email protected] organization of a cellular crescent. Clearly, that process impli- cates more than just cell proliferation. Therefore, in this study, 1046-6673/1210-2060 Journal of the American Society of Nephrology we focused on the morphologic alterations of the parietal Copyright © 2001 by the American Society of Nephrology epithelium in the early stages of crescent formation. To this J Am Soc Nephrol 12: 2060–2071, 2001 Podocyte Bridges in Glomerulonephritis 2061 aim, we used a murine model of crescentic glomerulonephritis Immunohistochemistry in which the disease is induced by intravenous injection of an Paraffin sections of 3-␮m thickness were rehydrated in alcohol anti-GBM serum in preimmunized mice. The pathology relies series and finally in phosphate-buffered saline (PBS). For detection of on a cellular immune response, with virtually no role of autol- macrophages, we used rat anti-mouse antibodies: anti-MHC class II ogous antibodies (12,13). We observed that formation of podo- (clone M5/114.15.2) and anti-F4/80 (clone CI:A3-1). Podocytes were cyte bridges between the GBM and the PBM is an early event identified with rabbit polyclonal antibodies against WT-1, CD2AP (both Santa Cruz Biotechnology, Santa Cruz, CA), ␣ integrin in this model of crescentic glomerulonephritis. 3 (Chemicon International Inc., Temecula, CA), synaptopodin, and podocin (both gifts from Dr. P. Mundel, Albert Einstein College of Materials and Methods Medicine, New York; a manuscript concerning the characterization of Animals podocin, by Schwarz K. et al., has been submitted for publication). Female C57BL/6 mice were obtained, specified pathogen-free, and Before the rabbit antibodies were used, the sections were submitted to kept in sterilized filter-top cages during the experimental period. 5 ϫ 5 min microwaving at 600 W. Detection was carried out with Manipulation of the animals was carried out on a sterile bench. The Vectastain ABC kits (Vector Laboratories, Burlingame, CA) with the experimental protocol was approved by the Cantonal Veterinary Of- use of peroxidase as label and diaminobenzidine as substrate. fice of Zurich. Results Induction of Anti-GBM Glomerulonephritis As found previously in this model (13,14), proteinuria Female mice, 13 wk old, were immunized by subcutaneous injec- started on day 2 after injection of the anti-GBM serum. On day tion of 0.2 mg of rabbit IgG (Jackson ImmunoResearch Laboratories, 3, many glomerular capillary loops displayed marked alter- West Grove, PA) in 0.2 ml of a 1:1 emulsion with complete Freund’s ations in the endocapillary compartment. On day 6, a broad adjuvant (Sigma, St. Louis, MO). Six days later (day 0), glomerulo- array of histologic alterations, ranging from almost normal nephritis was induced by intravenous injection of 0.4 ml of a 1:10 histology to fully developed cellular crescents, were seen dilution of rabbit anti-mouse GBM serum (14). Urinary protein con- among glomeruli of the same kidney. On day 10 after the centration was evaluated daily by use of dipsticks (Albustix; Miles, application of the serum, profound alterations were seen in West Haven, CT). virtually all glomeruli, and about 40% of them exhibited crescents. Fixation and Tissue Processing Mice were anesthetized with 17 mg/kg body weight xylasine hy- Histopathology of the Glomerular Tuft drochloride and 50 mg/kg body weight ketamine hydrochloride, in- A vivid endocapillary inflammation was encountered in traperitoneally. Kidneys were fixed by vascular perfusion via the abdominal aorta. The fixative consisted of 3% paraformaldehyde many glomeruli on day 3, but, at that time, the majority of (PFA) and 0.05% picric acid. It was dissolved in a 3:2 mixture of 0.1 capillary loops still appeared healthy. On day 6 endocapillary M cacodylate buffer (pH 7.4, adjusted to 300 mOsm with sucrose) and injuries were more widespread, and on day 10 only few loops 10% hydroxyethyl starch in saline (HAES; Fresenius AG, Germany). displayed a normal structure. Qualitatively however, morpho- After 5 min of fixation in situ, the kidneys were removed and cut into logic alterations of the tuft remained similar from day 3 to day coronal slices. Some slices were embedded in paraffin. The remaining 10. tissue was immersed for at least 24 h in the 3% PFA fixative solution, Because of widespread mesangiolysis, mesangial spaces to which 0.5% glutardialdehyde was added. Thereafter, the tissue was were dramatically expanded. Subendothelial spaces created by postfixed in 1% OsO4 and embedded in epoxy resin. detachment of endothelium from the GBM contained variable amounts of a proteinaceous material (hyaline), cell processes Light Microscopy and Transmission of mesangial cells (which frequently had lost contact with the Electron Microscopy GBM), and inflammatory cells (Figures 1 through 3). In TEM, Light microscopical investigations were carried out on series of sparse filaments of fibrin could be detected amid of hyaline 100 sections of 1-␮m thickness, cut from epoxy resin-embedded material; conspicuous accumulation of fibrin was found in only tissue and stained with azure II–methylene blue. Additionally, series few capillary loops in TEM as well as by immunofluorescence ␮ of 16 sections of 5- m thickness were cut from paraffin-embedded (not shown).
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