Summary
Acute inflammatory cell-capillary endothelial cell interactions, related to injury and repair, were investigated light and electron microscopically in acute human bacterial pyelonephritis. In inflammatory infiltrate-adjacent microvessels, the small capillaries were completely occluded by leukocyte plugs and the large capillaries were densely filled with acute inflammatory cells adhering to the endothelium. Severe damage to small and large capillaries was observed around endothelium adherent, degranulated neutrophil granulocytes containing phagocytosed bacteria. There were spaces in the endothelium, degradation of the vascular basement membrane, of the perivascular interstitial matrix and of collagen fibrils, with fibrin deposition and vessel wall fragmentation. In the small capillaries relatively distant from the interstitial infiltrates, emigration of leukocytes was frequently seen. Around the escaping cells the endothelial lining displayed occasional discontinuities, allowing leakage of vascular fluid into the interstitial space. Some small capillaries not related to the infiltrate were occluded by fibrin thrombi with apparent damage to the endothelial cells and disruption of the capillary wall. Various reparative changes were noticed in association with this change including capillary neovascularization. The findings confirm the existence of polymorphonuclear leukocyte-mediated injury of capillaries during the development of inflammatory responses in acute pyelonephritis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baehner RL, Boxer LA, Allen JM, Davis J (1977) Autooxidation as a basis for altered function by polymorphonuclear leukocytes. Blood 50:327–335
Bevilacqua MP, Pober JS, Wheeler ME, Cotran RS, Gimbrone MA (1985) Interleukin-1 activation of vascular endothelium. Am J Pathol 121:393–403
Bohle A, Gärtner H-V, Laberke H-G, Krück F (1984) Die Niere. Schattauer, Stuttgart, pp 448–455
Braide M, Amundson B, Chien S, Bagge U (1984) Quantitative studies on the influence of leukocytes on the vascular resistance in a skeletal muscle preparation. Microvasc Res 27:331–352
Churg J, Cotran RS, Sinniah R, Sakaguchi H, Sobin LH (1985) Renal disease. Classification and atlas of tubulo-interstitial diseases. Igaku-Shoin, Tokyo, pp 21–27
Coe FL (1986) Clinical and laboratory assessment of the patient with renal disease. In: Brenner BM, Rector FC (eds) The kidney. 3rd edition, WB Saunders, Philadelphia, pp 703–732
Donohoe JF, Venkatachalam MA, Bernard DB, Levinsky NG (1978) Tubular leakage and obstruction after renal ischemia. Kidney Int 13:208–222
Engler RL, Schmid-Schönbein GW, Pavelec RS (1983) Leukocyte capillary plugging in myocardial ischemia and reperfusion in the dog. Am J Pathol 111:98–111
Faustmann PM, Dermietzel R (1985) Extravasation of polymorphonuclear leukocytes from the cerebral microvasculature. Cell Tissue Res 242:399–407
Glaumann B, Glaumann H, Berezesky IK, Trump BF (1977) Studies on cellular recovery from injury. Virchows Arch B (Cell Pathol) 24:1–18
Hammerschmidt DE, Harris PD, Wayland JH, Craddock PhR, Fracp MB, Jacob HS (1981) Complement-induced granulocyte aggregation in vivo. Am J Pathol 102:146–150
Harlan JM (1985) Leukocyte-endothelial interactions. Blood 65:513–525
Harlan JM, Schwartz BR, Reidy MA, Schwartz SM, Ochs HD, Harker AL (1985) Activated neutrophils disrupt endothelial monolayer integrity by an oxygen radical-independent mechanism. Lab Invest 52:141–150
Heptinstall RH (1983) Pathology of the kidney. 3rd edition, Little, Brown, Boston, pp 1323–1327
Hill GS, Clark RL (1972) A comparative angiographic, micro-angiographic, and histologic study of experimental pyelonephritis. Invest Radiol 7:33–47
Klebanoff SJ, Vadas MA, Harlan JM, Sparks LH, Gamble JF, Agosti JM, Waltersdorph AM (1986) Stimulation of neutrophils by tumor necrosis factor. J Immunol 136:4220–4225
Kriz W, Kaissling B (1985) Structural organization of the mammalian kidney. In: Seldin DW, Giebisch G (eds) The kidney: physiology and pathophysiology. Raven, New York, pp 265–315
Madri JA, Pratt BM (1986) Endothelial cell-matrix interactions: in vitro models of angiogenesis. J Histochem Cytochem 34:85–91
Movat HZ (1985) The inflammatory reaction. Elsevier, Amsterdam, pp 161–189
Movat HZ, Wasi S (1985) Severe microvascular injury induced by lysosomal releasates of human polymorphonuclear leukocytes. Am J Pathol 121:404–417
Nawroth PP, Bank I, Handley D, Cassimeris J, Chess L, Stern D (1986) Tumor necrosis factor/cachectin interacts with endothelial cell receptors to induce release of interleukin 1. J Exp Med 163:1363–1375
Nawroth PP, Stern DM (1986) Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med 163:740–745
Ossana PJ, Test ST, Matheson NR, Regiani S, Weiss SJ (1986) Oxidative regulation of neutrophil elastase-alpha-1-proteinase inhibitor interactions. J Clin Invest 77:1939–1951
Pawlowski NA, Abraham EL, Pontier S, Scott W, Cohn ZA (1985) Human monocyte-endothelial cell interaction in vitro. Proc Natl Acad Sci USA 82:8208–8212
Pober JS, Bevilacqua MP, Mendrick DL, Lapierre LA, Fiers W, Gimbrone MA (1986) Two distinct monokines, interleukin 1 and tumor necrosis factor, each independently induce biosynthesis and transient expression of the same antigen on the surface of cultured human vascular endothelial cells. J Immunol 136:1680–1687
Reimer KA, Ganote ChE, Jennings RB (1972) Alterations in renal cortex following ischemic injury. Lab Invest 26:347–363
Richman AV, Gerber LI, Balis JU (1980) Peritubular capillaries. A major target site of endotoxin-induced vascular injury in the primate kidney. Lab Invest 43:327–332
Rubin RH, Tolkoff-Rubin NE, Cotran RS (1986) Urinary tract infection, pyelonephritis, and reflux nephropathy. In: Brenner BM, Rector FC (eds) The kidney. 3rd edition, Saunders, Philadelphia, pp 1085–1141
Smedley LA, Tonnesen MG, Sandhaus RA, Haslett C, Guthrie LA, Johnston RB, Henson PM, Worthen GS (1986) Neutrophil-mediated injury to endothelial cells. J Clin Invest 77:1233–1243
Stern D, Nawroth P, Handley D, Kisiel W (1985) An endothelial pathway of coagulation. Proc Natl Acad Sci USA 82:2523–2527
Thoenes W (1964) Mikromorphologie des Nephron nach temporärer Ischämie. Zwangl. Abh. a. d. Geb. d. norm. u. path. Anat., H. 15. Thieme, Stuttgart
Venkatachalam MA, Bernard DB, Donohoe JF, Levinsky NG (1978) Ischemic damage and repair in the rat proximal tubule. Kidney Int 14:31–49
Weiss SJ, Peppin G, Ortiz X, Ragsdale C, Test ST (1985) Oxidative autoactivation of latent collagenase by human neutrophils. Science 227:747–749
Weiss SJ, Curnutte JT, Regiani S (1986) Neutrophil-mediated solubilization of the subendothelial matrix. J Immunol 136:636–641
Zollinger HU, Mihatsch MJ (1978) Renal pathology in biopsy. Springer, Berlin, Heidelberg, New York, pp 424–436
Author information
Authors and Affiliations
Additional information
A Fellow of the Deutscher Akademischer Austauschdienst, Bonn, FRG
Rights and permissions
About this article
Cite this article
Iványi, B., Thoenes, W. Microvascular injury and repair in acute human bacterial pyelonephritis. Vichows Archiv A Pathol Anat 411, 257–265 (1987). https://doi.org/10.1007/BF00735032
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00735032