Nonenzymatic Glycosylation-induced Modifications of Intact Bovine Kidney Tubular Basement Membrane

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We examined structural changes in bovine kidney tubular basement membrane (TBM) following in vitro nonenzymatic glycosylation (NEG).Isolated TBM was incubated for 2 wk at 37 degrees C in the absence of sugar or in the presence of either glucose or ribitol under conditions that minimized degradation and oxidative damage. NEG and crosslink formation in glycated TBM were confirmed by decreased solubility, increased amounts of low mobility material by SDS-PAGE, and increased specific fluorescence compared to controls. Morphological analysis using high resolution, low voltage scanning electron microscopy (LV-SEM) revealed a complex three-dimensional meshwork of interconnecting strands with intervening openings. Glycated TBM underwent distinct morphological changes, including a 58% increase in the amount of image surface area occupied by openings. This was due to an apparent increase in the number of large openings (diameters > 12.5 nm), whereas the number of small openings (diameters < 12.5 nm) remained unchanged. These findings corroborate earlier physiological studies, which established that the loss of glomerular permselectivity seen in patients with diabetic nephropathy is due to the formation of large pores in the kidney filtration barrier of which the BM is a major component. We conclude that NEG and crosslink formation among BM components lead to modifications of BM ultrastructure, which could play a role in loss of barrier function in diabetic microangiopathy and nephropathy. (J. Clin. Invest. 1993. 92:3045-3052.) Key words: diabetes. microangiopathy. nephropathy. scanning electron microscopy. advanced glycosylation endproducts

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