Endotoxin and nanobacteria in polycystic kidney disease

被引:80
作者
Hjelle, JT
Miller-Hjelle, MA
Poxton, IR
Kajander, EO
Ciftcioglu, N
Jones, ML
Caughey, RC
Brown, R
Millikin, PD
Darras, FS
机构
[1] Univ Illinois, Coll Med, Dept Biomed & Therapeut Sci, Peoria, IL 61656 USA
[2] Univ Illinois, Coll Med, Dept Pathol, Peoria, IL 61656 USA
[3] Univ Illinois, Coll Med, Dept Surg, Peoria, IL 61656 USA
[4] Univ Edinburgh, Sch Med, Dept Med Microbiol, Edinburgh EH8 9AG, Midlothian, Scotland
[5] Univ Kuopio, Dept Biochem, FIN-70211 Kuopio, Finland
关键词
Chlamydia; Bartonella; Bacteroides; liver cysts; simple cystic disease; tetracycline; citrate;
D O I
10.1046/j.1523-1755.2000.00096.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background. Microbes have been suspected as provocateurs of polycystic kidney disease (PKD), but attempts to isolate viable organisms have failed. Bacterial endotoxin is the most often reported microbial product found in PKD fluids. We assessed potential microbial origins of endotoxin in cyst fluids from 13 PKD patients and urines of PKD and control individuals. Methods. Fluids were probed for endotoxin and nanobacteria, a new bacterium, by the differential Limulus Amebocyte Lysate ass ay (dLAL), genus-specific antilipopolysaccharide (LPS) antibodies, monoclonal antibodies to nanobacteria, and hyperimmune serum to Bartonella henselae (HS-Bh). Selected specimens were also assessed by transmission electron microscopy (TEM) and nanobacterial culture methods. Results. LPS or its antigenic metabolites were found in more than 75% of cyst fluids tested. Nanobacteria were cultured from 11 of 13 PKD kidneys, visualized in 8 of 8 kidneys by TEM, and immunodetected in all 13 PKD kidneys. By immunodetection, nanobacterial antigens were found in urine from 7 of 7 PKD males, 1 of 7 PKD females, 3 of 10 normal males, and 1 of 10 normal females. "Nanobacterium sanguineum" was dLAL positive and cross-reactive with antichlamydial LPS and HS-Bh. Some cyst fluids were also positive for LPS antigens from Escherichia coli, Bacteroides fragilis and/or Chlamydia, and HS-Bh, as were liver cyst fluids from one patient. Tetracycline and citrate inhibited nanobacterial growth in vitro. Conclusion. Nanobacteria or its antigens were present in PKD kidney, liver, and urine. The identification of candidate microbial pathogens is the first step in ascertaining their contribution, if any, to human disease.
引用
收藏
页码:2360 / 2374
页数:15
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