Research Article| Volume 76, ISSUE 3, P357-360, September 1970

The distribution of serum albumin in the diseased human nephron as demonstrated by immunofluorescence

  • Victor E. Pollak
    Reprint requests: Victor E. Pollak, M.D., Michael Reese Hospital, 29th St. and Ellis Ave., 514 Dreyfus, Chicago, Ill. 60616.
    From the Renal Division, Department of Medicine, Michael Reese Hospital and Medical Center Chicago, Ill. U.S.A.
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  • Boon Seng Ooi
    From the Renal Division, Department of Medicine, Michael Reese Hospital and Medical Center Chicago, Ill. U.S.A.
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  • Amadeo J. Pesce
    From the Renal Division, Department of Medicine, Michael Reese Hospital and Medical Center Chicago, Ill. U.S.A.
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  • Author Footnotes
    ∗ Fellow of the China Medical Board of New York. Present address: Department of Clinical Medicine, University of Singapore, Singapore.
    ∗∗ Established Investigator, American Heart Association.
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      Albumin in tissue is particularly susceptible to solubilization in aqueous solutions. Because of this and the consequent diffusion artifacts, studies of the distribution of serum albumin in tissue sections have usually been unrewarding. A freeze-substitution technique was therefore applied to specimens of renal tissue obtained by percutaneous renal biopsy. With the use of this technique, serum proteins, including albumin, were fixed effectively in situ without apparent diffusion artifacts. A fluorescein isothiocyanate-conjugated rabbit antihuman albumin antiserum was used to study the distribution of serum albumin in 30 renal biopsy specimens from patients with diverse diseases affecting the kidney. A striking finding was the universal distribution of albumin in the interstitial space, both within the peritubular capillaries and in the extravascular compartment, thereby confirming physiologic observations on the extravascular distribution of albumin in the kidney. In the glomerulus albumin was observed invariably in the glomerular capillaries and frequently in both mesangium and visceral epithelial cells; it was detected in Bowman's space in only 8 of 30 specimens. Albumin was detected frequently as discrete droplets in the lumen and cytoplasm of the proximal convoluted tubules; droplets of albumin were found only occasionally in cells of the distal convolutions, loops of Henle, and collecting ducts. A common finding in the distal parts of the nephron was a diffuse distribution of albumin in the cytoplasm of single or multiple cells or in the intercellular spaces. These observations suggest that, in addition to proximal tubular reabsorption, albumin is transported through the cells of distal convolutions, loops of Henle, and collecting ducts.
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