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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Med.</journal-id>
<journal-title>Frontiers in Medicine</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Med.</abbrev-journal-title>
<issn pub-type="epub">2296-858X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fmed.2022.861566</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Medicine</subject>
<subj-group>
<subject>General Commentary</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Commentary: The Glomerular Endothelium Restricts Albumin Filtration</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name><surname>Comper</surname> <given-names>Wayne D.</given-names></name>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1649656/overview"/>
</contrib>
</contrib-group>
<aff><institution>Salaqua Diagnostics Inc</institution>, <addr-line>New York, NY</addr-line>, <country>United States</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Zaid A. Abassi, Technion Israel Institute of Technology, Israel</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Samuel Heyman, Hadassah Hebrew University Hospitals, Israel</p></fn>
<corresp id="c001">&#x0002A;Correspondence: Wayne D. Comper<email>wcomper&#x00040;hotmail.com</email></corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Nephrology, a section of the journal Frontiers in Medicine</p></fn></author-notes>
<pub-date pub-type="epub">
<day>28</day>
<month>02</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>9</volume>
<elocation-id>861566</elocation-id>
<history>
<date date-type="received">
<day>24</day>
<month>01</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>07</day>
<month>02</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2022 Comper.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Comper</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license> </permissions>
<related-article id="RA1" related-article-type="commentary-article" journal-id="Front Med" journal-id-type="nlm-ta" vol="8" page="766689" xlink:href="34912827" ext-link-type="pubmed">A Commentary on <article-title>The Glomerular Endothelium Restricts Albumin Filtration</article-title> by Ballermann, B. J., Nystr&#x000F6;m, J., and Haraldsson, B. (2021). Front. Med. 8:766689. doi: <object-id>10.3389/fmed.2021.766689</object-id></related-article> <kwd-group>
<kwd>charge selectivity</kwd>
<kwd>glomerular filtration of proteins</kwd>
<kwd>glomerular filtration barrier</kwd>
<kwd>cold isolated kidney perfusion</kwd>
<kwd>glycosaminoglycans</kwd>
</kwd-group>
<counts>
<fig-count count="0"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="14"/>
<page-count count="2"/>
<word-count count="1135"/>
</counts>
</article-meta>
</front>
<body>
<p>Contrary to the claims of Ballermann et al. (<xref ref-type="bibr" rid="B1">1</xref>) that &#x0201C;the glomerular endothelium bars the bulk of albumin from passing to the ultrafiltrate,&#x0201D; the results from the famous physiologist/thermodynamicist AG Ogston and his colleagues at Oxford would make you argue the opposite. Ogston and Preston measured the two types of albumin interaction with glycosaminoglycan chains (the major constituent of the endothelium) including equilibrium interactions reflecting excluded volume (<xref ref-type="bibr" rid="B2">2</xref>, <xref ref-type="bibr" rid="B3">3</xref>) and transport interactions representing dynamic interactions (<xref ref-type="bibr" rid="B4">4</xref>) under physiological conditions. Ogston et al. found both interactions quantitatively small and unremarkable and not related to charge. When considering the extracellular partitioning of albumin from the capillary into the glomerular filtrate to be of the order of 1:0.0006 then Ogston&#x00027;s data would be hard pressed to account for a ratio of 1:0.4 (<xref ref-type="bibr" rid="B5">5</xref>).</p>
<p>Ballermann et al. (<xref ref-type="bibr" rid="B1">1</xref>) also surprisingly continue to cite work from Haraldsson&#x00027;s group (<xref ref-type="bibr" rid="B6">6</xref>&#x02013;<xref ref-type="bibr" rid="B9">9</xref>) on the cold isolated kidney perfusion (cIPK) technique. The technique has been discredited for some time (<xref ref-type="bibr" rid="B10">10</xref>) particularly in relation to apparent &#x0201C;charge selectivity&#x0201D; without the criticism being addressed. The claim of glomerular charge selectivity resides in differences in the fractional clearance of albumin and that of uncharged Ficoll of the same hydrodynamic radius of 36&#x000C5;. It turns out that these fractional clearance differences are near maximal at very low glomerular filtration rates (GFR) (&#x0003C;10% of normal). In fact, they routinely run their cIPKs at these low GFRs. Yet, when the operating GFR is increased to 50% normal the fractional clearance differences decrease by 90%. Extrapolation to normal GFR would indicate that there are no differences at all (<xref ref-type="bibr" rid="B10">10</xref>). The conclusion from these studies is that the apparent &#x0201C;charge selectivity&#x0201D; is massively dependent on GFR whereas genuine charge selectivity should be completely independent of it. Clearly there are other non-charge related factors determining this GFR dependence in fractional clearance (<xref ref-type="bibr" rid="B10">10</xref>). Other studies by this group have utilized various enzyme and chemical treatments of the kidney to affect the charge components of the endothelium and glomerular filtration barrier as a whole but the phenomenology of these studies is hardly the basis to establish a basic force in Nature.</p>
<p>In terms of the biophysics of albumin transglomerular transport the conclusion, from using inert transport probes that are not metabolized by kidney cells, is that charge selectivity does not exist (<xref ref-type="bibr" rid="B11">11</xref>&#x02013;<xref ref-type="bibr" rid="B14">14</xref>); it is a flawed concept consistent with the original observations of Ogston et al. Therefore, while the endothelium may have a very mild effect on the size exclusion of albumin, its basic role in restricting the bulk of albumin filtration has been overstated.</p>
<sec id="s1">
<title>Author Contributions</title>
<p>WDC has been instrumental over the last 25 years in examining the biophysics transglomerular transport of proteins and delineating those concepts that are relevant and experimentally validated.</p></sec>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of Interest</title>
<p>WDC was employed by company Salaqua Diagnostics Inc.</p></sec>
<sec sec-type="disclaimer" id="s2">
<title>Publisher&#x00027;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p></sec> </body>
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