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Brazilian Journal of Medical and Biological Research

Print version ISSN 0100-879XOn-line version ISSN 1414-431X

Braz J Med Biol Res vol.33 n.1 Ribeirão Preto Jan. 2000 

Braz J Med Biol Res, January 2000, Volume 33(1) 111-118

Mechanisms involved in calcium oxalate endocytosis by Madin-Darby canine kidney cells

A.H. Campos and N. Schor

Divisão de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil

down.gif (51 bytes) Abstract
Material and Methods
Correspondence and Footnotes


Calcium oxalate (CaOx) crystals adhere to and are internalized by tubular renal cells and it seems that this interaction is related (positively or negatively) to the appearance of urinary calculi. The present study analyzes a series of mechanisms possibly involved in CaOx uptake by Madin-Darby canine kidney (MDCK) cells. CaOx crystals were added to MDCK cell cultures and endocytosis was evaluated by polarized light microscopy. This process was inhibited by an increase in intracellular calcium by means of ionomycin (100 nM; N = 6; 43.9% inhibition; P<0.001) or thapsigargin (1 µM; N = 6; 33.3% inhibition; P<0.005) administration, and via blockade of cytoskeleton assembly by the addition of colchicine (10 µM; N = 8; 46.1% inhibition; P<0.001) or cytochalasin B (10 µM; N = 8; 34.2% inhibition; P<0.001). Furthermore, CaOx uptake was reduced when the activity of protein kinase C was inhibited by staurosporine (10 nM; N = 6; 44% inhibition; P<0.01), or that of cyclo-oxygenase by indomethacin (3 µM; N = 12; 17.2% inhibition; P<0.05); however, the uptake was unaffected by modulation of potassium channel activity with glibenclamide (3 µM; N = 6), tetraethylammonium (1 mM; N = 6) or cromakalim (1 µM; N = 6). Taken together, these data indicate that the process of CaOx internalization by renal tubular cells is similar to the endocytosis reported for other systems. These findings may be relevant to cellular phenomena involved in early stages of the formation of renal stones.

Key words: alcium oxalate, DCK cells, mechanisms of endocytosis, renal stone


Calcium oxalate (CaOx) crystals, the main constituent of urinary calculi, adhere in a specific manner to the plasma membrane of renal tubular epithelial cells in vitro and in vivo, and this process is rapidly followed by endocytosis. The tubular cells then exhibit a proliferative response, rearranging the cytoskeleton, increasing expression of "early-immediate" transcription genes (c-myc, c-fos, nur-77), synthesizing fibrogenic substances such as platelet-derived growth factor and connective tissue growth factor, and increasing absolute cell counts and viability (for a review, see Ref. 1).

There are controversies about the elements required for the development of urinary calculi. Although the exact role of the above mentioned phenomena has not been defined, recent experimental and clinical evidence points to the interaction between CaOx crystals and renal tubular epithelium as a factor involved in the genesis of urolithiasis. As observed in cell cultures, human kidney cells internalize crystals and proliferate when exposed to high concentrations of CaOx in vivo (e.g. primary hyperoxaluria, Crohn's disease-related malabsorption; 2,3). CaOx-induced excessive cell proliferation or damage (at higher concentrations) could lead to detachment of epithelial cells and basal membrane exposure. Epithelial denudation would permit a more intensive crystal adhesion (4,5). Additional anchoring of CaOx particles would follow, allowing an expressive crystal nucleation and calculus growth (6). The traffic of particles through the basement membrane or even through intact tubular epithelium could also explain the presence of CaOx crystals in tubular interstitium. Considering the CaOx stimulus of proliferation, interstitial scarring sometimes seen in urolithiasis could also be a consequence of CaOx internalization by tubular cells.

Different substances have been described as modulators of adhesion and/or endocytosis processes. Nevertheless, despite the possible relevance of the CaOx-tubular cell interaction, none of these drugs seems to be suitable for clinical use (1,7-12). The cellular pathways involved in endocytosis of CaOx crystals can constitute potential targets for drugs designed for the prophylaxis and/or treatment of urolithiasis. However, the mechanisms by which tubular cells take up CaOx need additional investigation.

The objective of the present study was to further clarify the cellular events related to this particular type of endocytosis employing Madin-Darby canine kidney (MDCK) cell culture.

Material and Methods

Cell culture

MDCK cells obtained from ATCC (American Type Culture Collection, Rockville, MD, USA) were cultured in Dulbecco's modified Eagle's medium (DMEM) supplemented with fetal bovine serum (FBS; 5%), 2 g/l NaHCO3, 2.6 g/l HEPES, 10.000 IU/l penicillin, 50 mg/l streptomycin and 100 mg/l neomycin. Cells were placed in polystyrene bottles at 37oC in a humidified gas mixture (95% air and 5% CO2). Before each experiment cells were kept in DMEM without FBS for 24 h in order to obtain cells in the G0 phase of the cell cycle. At maximal confluence, cell treatments were performed and cell suspensions were obtained by exposure to trypsin-EDTA solution (0.25/0.02%, w/v, 0.5 ml/bottle). Cell viability was evaluated by the lactate dehydrogenase (LDH) assay (13) and confirmed by Trypan blue dye (0.2%; 5 to 15 min) exclusion. Values higher than 90% in both methods were considered adequate.

Preparation of calcium oxalate (CaOx) crystals

Equimolar solutions (0.4 M, 100 ml) of calcium chloride and potassium oxalate were combined and the mixture was added to distilled and deionized water (DDW, 300 ml) by constant dripping for 2 h. This suspension was maintained under continuous stirring at 75oC for 5 h and then washed with DDW to remove potassium chloride present in the supernatant. The remaining saturated solution was maintained at 37oC for 15 days until CaOx crystallization. CaOx crystals were then sterilized in ethylene oxide and culture medium without FBS was added, yielding a new suspension. In order to uniformize particle size, the suspension was sonicated for 12 min. Qualitative analysis of CaOx was performed by X-ray diffractometry and crystal size was evaluated by laser chromatography with a CILAS 330 laser granulometer.

MDCK cell exposure to CaOx

Confluent cell cultures were washed twice with PBS and exposed to the CaOx suspension (200 µg/ml) for different periods of time (2, 6 and 24 h). Cultures were then washed again in PBS and trypsinized. These procedures yield only cells containing internalized or strongly adhered crystals. Cell suspensions were analyzed by polarized light microscopy and CaOx crystal endocytosis was scored arbitrarily on a 0 to 4 scale, according to a previous report (14), as follows: 0 for cells without intracellular CaOx crystals, 1 for cells containing a single small CaOx crystal, 2 for cells with less than 50% of the cytoplasm area occupied by CaOx crystals, 3 for cells with 50 to 75% of the cytoplasm area filled with CaOx crystals, and 4 for cells with more than 75% of the cytoplasm area occupied by CaOx crystals. At least 100 cells per sample were counted and the final score was calculated according to the equation: (score 0 cells x 0) + (score 1 cells x 1) + (score 2 cells x 2) + (score 3 cells x 3) + (score 4 cells x 4)/total number of cells. In another set of experiments, after determination of the best incubation period, cells were exposed to different concentrations of CaOx (10, 50, 100, 200 and 300 µg/ml) for 6 h and the CaOx cell uptake was evaluated. The intracellular position of CaOx crystals was confirmed in some representative cell cultures at different incubation times by laser scanning confocal microscopy (BioRad 1024-UV confocal system coupled to a microscope Zeiss Axiovert 100, BioRad, Hercules, CA, USA).

Effect of different drugs on CaOx crystal endocytosis

MDCK cells were exposed to CaOx (200 µg/ml, 6 h) in the absence (vehicle only) or in the presence of each of the following drugs, added to the medium at submaximal concentrations 30 min before CaOx administration: 10 nM staurosporine (a protein kinase C inhibitor), 3 µM indomethacin (a cyclo-oxygenase inhibitor), 3 µM glibenclamide (an ATP-sensitive potassium channel blocker), 1 mM tetraethylammonium (a nonspecific potassium channel blocker), 1 µM cromakalim (an ATP-sensitive potassium channel opener), 100 nM ionomycin (a calcium ionophore), 1 µM thapsigargin (an endoplasmic reticulum calcium ATPase inhibitor), 10 nM nifedipine (a voltage-dependent calcium channel blocker), 10 µM colchicine (a microtubule assembly inhibitor) or 10 µM cytochalasin B (an actin microfilament assembly inhibitor). CaOx crystal uptake was then evaluated as described above.

Statistical analysis

Data related to CaOx endocytosis were reported as mean scores ± standard error of the mean (SEM). When different groups were compared, data were presented as percent of control (absolute values in the text). Laser granulometry results were expressed as non-cumulative frequency of distribution of crystal sizes in only one sample. After log transformation of raw data, experimental and control groups were compared by the unpaired Student t-test. P values of less than 0.05 were considered significant.

Drugs and reagents

PBS, DMEM, penicillin/streptomycin/neomycin solution, Triton X-100, NADH, sodium pyruvate, Tris-HCl, Trypan blue, ionomycin, indomethacin, colchicine, nifedipine, thapsigargin, tetraethylammonium, cromakalim, cytochalasin B, and glibenclamide were purchased from Sigma Chemical Co. (St. Louis, MO, USA). Trypsin-EDTA solution and FBS were obtained from Sigma Chemical Co. or Cultilab (Campinas, SP, Brazil). Ethanol P.A., DMSO and all salts were purchased from Merck S.A. (Rio de Janeiro, RJ, Brazil). Staurosporine was supplied by Calbiochem-Novabiochem Co. (La Jolla, CA, USA). Glibenclamide, staurosporine and cytochalasin B were dissolved in DMSO. Ionomycin, indomethacin, nifedipine and cromakalim were dissolved in ethanol. The remaining substances were dissolved in DDW or 0.9% NaCl. The final concentrations of ethanol or DMSO in the culture medium never exceeded 0.01%. We assured that these substances had no detectable effect on cell viability or CaOx endocytosis process.


Physical characteristics of CaOx crystals

CaOx sample analysis by X-ray diffractometry yielded a purity grade higher than 95. The mean and median size of CaOx crystals in a single sample evaluated by laser granulometry was 3.94 and 4.99 µm, respectively (data not shown).

Time- and concentration-dependent CaOx endocytosis

MDCK cells internalized CaOx crystals in a time-dependent manner. As can be seen in Figure 1A, the score obtained after a 2-h exposure period was 0.67 ± 0.04, reaching 1.09 ± 0.08 at 6 h (N = 6; P<0.001). The magnitude of endocytosis did not change significantly after 24 h of incubation (N = 6; P = ns). At 6 h, MDCK endocytosis exhibited a concentration-dependent pattern from 10 to 300 µg/ml (0.11 ± 0.01 to 1.43 ± 0.11; N = 6-34) (Figure 1B). Although the concentration-response curve did not reach a plateau, higher CaOx concentrations were not employed due to cytotoxicity. Cell viability was not impaired by exposure to CaOx (200 µg/ml) for 6 h, with a mean intracellular LDH activity of 99.2 ± 0.3% and 98.7 ± 0.4% (N = 6; P = ns) for control and exposed cells, respectively (Figure 1C).

Figure 1 - A, Time-response internalization of calcium oxalate (CaOx) crystals (200 µg/ml) by MDCK cells. *P<0.001 compared to 6 and 24 h (Student t-test). B, Concentration-response curve for CaOx crystal internalization by MDCK cells after a 6-h exposure period. C, Viability of MDCK cells with (closed column) or without (open column) CaOx exposure for 6 h expressed as percentage of intra- and extracellular lactate dehydrogenase (LDH) activity. The columns represent the mean and the bars the SEM of at least 6 experiments..0

[View larger version of this image (20 K GIF file)]

Effect of different drugs on CaOx endocytosis

As can be observed in Figure 2A, increasing [Ca2+]i by means of endoplasmic reticulum Ca2+-ATPase blockade with thapsigargin significantly inhibited the endocytotic response of MDCK cells (33.3% inhibition; N = 6; P<0.005). Similar results were obtained when [Ca2+]i was enhanced by changing plasma membrane permeability to extracellular calcium with ionomycin (43.9% inhibition; N = 6; P<0.001). On the other hand, the inhibition of voltage-dependent calcium channels by nifedipine did not promote alterations in cellular CaOx uptake (N = 6; P = ns) (Figure 2A). The absolute scores of the control groups compared to the thapsigargin, ionomycin and nifedipine groups were 1.32 ± 0.10, 1.27 ± 0.06 and 1.22 ± 0.06 (N = 6), respectively.

Figure 2 - Effect of different drugs on CaOx crystal endocytosis (200 µg/ml, 6 h exposure time) by MDCK cells. Data are reported as percentage of control mean endocytosis scores. The columns represent the mean and the bars the SEM of at least 6 experiments. A, Thapsigargin (Thaps, 1 µM), ionomycin (Iono, 100 nM) and nifedipine (Nfdp, 10 nM). *P<0.005 compared to control (C) (Student t-test). B, Staurosporine (Stau, 10 nM) and indomethacin (Indo, 3 µM). *P<0.05 compared to control (C) (Student t-test). C, Colchicine (Clch, 10 µM) and cytochalasin B (Cyto B, 10 µM). *P<0.001 compared to control (C) (Student t-test). D, Glibenclamide (Glbd, 3 µM), cromakalim (Crmk, 1 µM) and tetraethylammonium (TEA, 1 mM).

[View larger version of this image (16 K GIF file)]

Staurosporine markedly reduced (44% of control; N = 6; P<0.01) the uptake of CaOx crystals after an exposure time of 6 h (Figure 2B). On the other hand, indomethacin had only a discrete, although statistically significant, inhibitory effect on CaOx endocytosis (17.2% of control; N = 12; P<0.05) (Figure 2B). The scores obtained for the control groups were 1.32 ± 0.10 (N = 6) and 1.22 ± 0.03 (N = 12) for staurosporine and indomethacin, respectively.

According to the data in Figure 2C, the inhibition of actin microfilament assembly by cytochalasin B significantly decreased the endocytotic response of MDCK cells (34.2% of control; N = 8; P<0.001). Similarly, colchicine, a microtubule formation inhibitor, significantly reduced CaOx uptake by tubular cells (46.1% of control; N = 8; P<0.001). The control absolute score for both groups was 1.17 ± 0.05 (N = 6).

The activation or the inhibition of ATP-sensitive potassium channels by cromakalim and glibenclamide, respectively, did not alter significantly CaOx endocytosis (N = 6; P = ns). Similarly, the tetraethylammonium-induced nonspecific blockade of potassium channels did not change the cytosolic CaOx content of MDCK cells exposed to relatively high crystal concentrations (N = 6; P = ns) (Figure 2D).


Our technique for CaOx crystal production provided particles with dimensions and purity grade suitable for performing endocytosis assays. Moreover, the analysis of CaOx endocytosis kinetics confirmed previous data (15), showing that MDCK cells take up CaOx crystals in a time- and concentration-dependent manner, without detection of cell toxicity at the several concentrations tested, further validating our methods.

Alterations in [Ca2+]i play an important role in endocytosis and intracellular transport (16,17). Enhancements in [Ca2+]i from extra- or intracellular calcium sources induced by ionomycin and thapsigargin, respectively, significantly inhibited the MDCK cell CaOx internalization. On the other hand, in our study, the blockade of calcium influx via voltage-dependent channels by nifedipine did not promote relevant changes in crystal internalization. Indeed, a direct causative relationship between massive increments in intracellular calcium and endocytotic process inhibition has not been determined, as shown by Wu and Betz (18). The use of different calcium channel blockers and the measurement of [Ca2+]i in MDCK cells after crystal internalization could help us solve this question.

Different investigators have reported considerable decreases of endocytosis in different models using protein kinase C inhibitors, with special emphasis on plasma membrane receptor recycling (19,20). This phenomenon does not only apply to protein endocytosis and was well documented in MDCK cells when activators (such as derivatives of phorbol esters) and/or inhibitors of protein kinase C were employed (21,22). This fact was evident also in the present study, with marked inhibition of CaOx internalization after exposure to staurosporine.

Another enzyme involved in the mechanisms of endocytosis is cyclo-oxygenase. Singhal et al. (23), for instance, have demonstrated the production of prostaglandin E2 by rat mesangial cells following colloidal gold particle internalization. In our model, indomethacin induced a slight inhibitory response, indicating a minor role for cyclo-oxygenase in CaOx endocytosis. Curiously, Lieske et al. (24) reported an inhibitory effect on CaOx endocytosis after administration of arachidonic acid (AA) and some of its metabolites (PGE1 and PGE2) to MDCK cells. Thus, the involvement of AA cascade metabolites in these events deserves further investigation.

Cytochalasin B or colchicine also significantly reduced cellular CaOx crystal uptake. Several studies have demonstrated the participation of the cytoskeleton in endocytotic processes by inhibition of microtubules and/or actin microfilament assembly (25-27). This especially occurs in epithelial cells where actin filaments and tubulin are relevant not only for cell polarity establishment and maintenance, but also for the intra- and transcellular process of particle distribution. The earlier intracellular events triggered by CaOx are related to the cytoskeleton. As already observed elsewhere, tubular cell crystal endocytosis is accompanied by F-actin concentration and cytokeratin net reorganization (28). Our data showed that alterations in the tubulin net are also present in this phenomenon, although data from Lieske et al. (28) pointed to an opposite direction. Furthermore, the inhibitory effect of cytochalasin B suggests that actin polymerization may be a more precocious event than CaOx crystal internalization, in contrast to the results of the above mentioned authors. However, although contradictory data exist, cytoskeleton mobilization is indispensable for the development of the CaOx internalization process by tubular epithelial cells.

Reductions in culture medium potassium concentration enhance CaOx internalization by tubular cells (1). In our study, potassium channel inhibitors (glibenclamide and tetraethylammonium) did not modify the magnitude of CaOx endocytosis by MDCK cells. The same occurred when the ATP-sensitive potassium channel activator, cromakalim, was employed, excluding the participation of some potassium channels in such phenomenon.

In conclusion, our study confirms and extends previous data showing that the process of CaOx uptake by tubular cells is inhibited by [Ca2+]i increases, cytoskeleton assembly blockade, protein kinase C and, to a lesser extent, cyclo-oxygenase inhibition, but not by potassium channel blockade or activation. Thus, MDCK cells employ mechanisms for CaOx internalization quite similar to those observed in several types of endocytosis. These results may contribute to a better understanding of a phenomenon probably related to the pathophysiology of urolithiasis.


1. Lieske JC & Toback FG (1996). Interaction of urinary crystals with renal epithelial cells in the pathogenesis of nephrolithiasis. Seminars in Nephrology, 16: 458-473.        [ Links ]

2. Saxon A, Busch GJ, Merrill JP, Franco V & Wilson RE (1974). Renal transplantation in primary hyperoxaluria. Archives of Internal Medicine, 133: 464-467.        [ Links ]

3. Mandell I, Krauss E & Millan JC (1980). Oxalate-induced acute renal failure in Crohn's disease. American Journal of Medicine, 69: 628-632.        [ Links ]

4. Khan SR, Finlayson B & Hackett RL (1982). Experimental calcium oxalate nephrolithiasis in the rat. American Journal of Pathology, 107: 59-69.        [ Links ]

5. Khan SR, Cockrell CA, Finlayson B & Hackett RL (1984). Crystal retention by injured urothelium of the rat urinary bladder. Journal of Urology, 132: 153-157.        [ Links ]

6. Khan SR, Shevock PN & Hackett RL (1990). Membrane associated crystallization of calcium oxalate in vitro. Calcified Tissue International, 46: 116-120.        [ Links ]

7. Lieske JC & Toback FG (1993). Regulation of renal epithelial cell endocytosis of calcium oxalate monohydrate crystals. American Journal of Physiology, 264: F800-F807.        [ Links ]

8. Verkoelen CF, Romijn JC, Cao LC, Boevé ER, De Bruijn WC & Schröder FH (1996). Crystal-cell interaction inhibition by polysaccharides. Journal of Urology, 155: 749-752.        [ Links ]

9. Lieske JC, Leonard R & Toback FG (1995). Adhesion of calcium oxalate monohydrate crystals to renal epithelial cells is inhibited by specific anions. American Journal of Physiology, 268: F604-F612.        [ Links ]

10. Parks JH & Coe FL (1986). Urine citrate and calcium in calcium nephrolithiasis. Advances in Experimental Medicine and Biology, 208: 445-449.        [ Links ]

11. Worcester EM, Nakagawa Y, Wabner CL, Kumar S & Coe FL (1988). Crystal adsorption and growth slowing by nephrocalcin, albumin, and Tamm-Horsfall protein. American Journal of Physiology, 255: F1197-F1205.        [ Links ]

12. Hess B, Nakagawa Y & Coe FL (1989). Inhibition of calcium oxalate monohydrate crystal aggregation by urine proteins. American Journal of Physiology, 257: F99-F106.        [ Links ]

13. Bergmeyer HV (1974). Methods in Enzymatic Analysis. Academic Press, New York, 574-589.        [ Links ]

14. Lieske JC, Walsh-Reitz MM & Toback FG (1992). Calcium oxalate monohydrate crystals are endocytosed by renal epithelial cells and induce proliferation. American Journal of Physiology, 262: F622-F630.        [ Links ]

15. Kohjimoto Y, Ebisuno S, Tamura M & Ohkawa T (1996). Interactions between calcium oxalate monohydrate crystals and Madin-Darby canine kidney cells: endocytosis and cell proliferation. Urological Research, 24: 193-199.        [ Links ]

16. Ninomiya Y, Kishimoto T, Miyashita Y & Kasai H (1996). Ca2+-dependent exocytotic pathways in Chinese hamster ovary fibroblasts revealed by a caged-Ca2+ compound. Journal of Biological Chemistry, 271: 17751-17754.        [ Links ]

17. Llorente A, Garred O, Holm PK, Eker P, Jacobsen J, Van Deurs B & Sandvig K (1996). Effect of calmodulin antagonists on endocytosis and intracellular transport of ricin in polarized MDCK cells. Experimental Cell Research, 227: 298-308.        [ Links ]

18. Wu LG & Betz WJ (1996). Nerve activity but not intracellular calcium determines the time course of endocytosis of the frog neuromuscular junction. Neuron, 17: 769-779.        [ Links ]

19. Moraru II, Laky M, Stanescu T, Buzila L & Popescu LM (1990). Protein kinase C controls Fc gamma receptor-mediated endocytosis in human neutrophils. FEBS Letters, 274: 93-95.        [ Links ]

20. Fallon RJ & Danaher M (1992). The effect of staurosporine, a protein kinase inhibitor, on asialoglycoprotein receptor endocytosis. Experimental Cell Research, 203: 420-426.        [ Links ]

21. Holm PK, Eker P, Sandvig K & Van Deurs B (1995). Phorbol myristate acetate selectively stimulates apical endocytosis via protein kinase C in polarized MDCK cells. Experimental Cell Research, 271: 157-168.        [ Links ]

22. Cardone MH, Smith BL, Song W, Mochly-Rosen D & Mostov KE (1994). Phorbol myristate acetate-mediated stimulation of transcytosis and apical recycling in MDCK cells. Journal of Cell Biology, 124: 717-727.        [ Links ]

23. Singhal PC, Ding GH, De Candido S, Franki N, Hays RM & Schlondorff D (1987). Endocytosis by cultured mesangial cells and associated changes in prostaglandin E2 synthesis. American Journal of Physiology, 252: F627-F634.        [ Links ]

24. Lieske JC, Norris R & Toback FG (1997). Calcium oxalate monohydrate crystal adhesion to renal epithelial cells is modulated by arachidonic acid and its metabolites. Journal of the American Society of Nephrology, 8: 564A (Abstract).        [ Links ]

25. Ramm GA, Powell LW & Halliday JW (1994). Pathways of intracellular trafficking and release of ferritin by the liver in vivo: the effect of chloroquine and cytochalasin D. Hepatology, 19: 504-513.        [ Links ]

26. Lamaze C, Fujimoto LM, Yin HL & Schmid SL (1997). The actin cytoskeleton is required for receptor-mediated endocytosis in mammalian cells. Journal of Biological Chemistry, 272: 20332-20335.        [ Links ]

27. Gottlieb TA, Ivanov IE, Adesnik M & Sabatini DD (1993). Actin microfilaments play a critical role in endocytosis at the apical but not the baso-lateral surface of polarized epithelial cells. Journal of Cell Biology, 120: 695-710.        [ Links ]

28. Lieske JC, Swift H, Martin T, Patterson B & Toback FG (1994). Renal epithelial cells rapidly bind and internalize calcium oxalate monohydrate crystals. Proceedings of the National Academy of Sciences, USA, 91: 6987-6991.        [ Links ]


We thank Prof. Dr. Neusa P. da Silva, and Simone M. Camargo, Clara V. Razvickas and Otoniel Ribas for technical assistance. We also thank Prof. Dr. Renato A. Mortara for the support involving confocal microscopy observations.

Correspondence and Footnotes

Address for correspondence: N. Schor, Rua Botucatu, 740, 04023-900 São Paulo, SP, Brasil. Fax: +55-11-573-9652. E-mail:

Presented in part at the 30th Annual Meeting of the American Society of Nephrology, San Antonio, TX, USA, November 1997. Research supported by FAPESP, FOR and CNPq. Received February 25, 1999. Accepted October 13, 1999.

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