Imai H, Wakui H, Ishino T, Komatsuda A, Nakamoto Y, Miura A B, Kobayashi R
Third Department of Internal Medicine, Akita University School of Medicine, Japan.
Clin Nephrol. 1992 Apr;37(4):169-76.
IgA immune complexes and polymeric IgA are presumed to play important roles in the development and progression of IgA nephropathy. Complex-forming glycoprotein heterogenous in charge (protein HC), being inhibitors of neutrophilic chemotaxis, has been reported as binding to IgA. As a working hypothesis it was assumed that complexes of protein HC and IgA are present in glomeruli from IgA nephropathy patient in stable state. In this study, we examined the glomerular deposition of protein HC in 40 patients with IgA nephropathy and in 10 patients with non-IgA nephropathy. We used highly specific antibody against protein HC, that does not cross-react with alpha-1-microglobulin. An immunofluorescent study revealed that 10 out of the 40 patients (25%) showed an intensity of 1+, 16 (40%) showed weak positive (+/-), and the other 14 (35%) were negative. There was no deposition of protein HC in non-IgA nephropathy patients. Histopathological analysis demonstrated a significant correlation between the intensity of glomerular-deposited protein HC and pathological activity (p less than 0.005); the latter was defined as having either crescents in more than 15% of the remaining glomeruli (excluding global sclerotic glomeruli), or segmental necrosis or sclerosis in more than 30% of the remaining glomeruli. A significant correlation was observed between pathological activity and the intensity of deposited IgG, IgA and IgM (p = 0.01), and lambda chain (p less than 0.005). Considering anti-inflammatory activity of protein HC, these results suggest that protein HC cannot protect sufficiently acute inflammation or tissue damages due to co-deposited IgG and IgM and/or other factors.(ABSTRACT TRUNCATED AT 250 WORDS)
IgA免疫复合物和聚合IgA被认为在IgA肾病的发生和发展中起重要作用。电荷不均一的复合形成糖蛋白(蛋白HC)作为嗜中性粒细胞趋化作用的抑制剂,已被报道可与IgA结合。作为一个工作假设,假定蛋白HC和IgA的复合物以稳定状态存在于IgA肾病患者的肾小球中。在本研究中,我们检测了40例IgA肾病患者和10例非IgA肾病患者肾小球中蛋白HC的沉积情况。我们使用了针对蛋白HC的高度特异性抗体,该抗体与α-1-微球蛋白无交叉反应。免疫荧光研究显示,40例患者中有10例(25%)显示强度为1+,16例(40%)显示弱阳性(+/-),另外14例(35%)为阴性。非IgA肾病患者中未检测到蛋白HC的沉积。组织病理学分析表明,肾小球沉积的蛋白HC强度与病理活性之间存在显著相关性(p<0.005);后者定义为在超过15%的剩余肾小球(不包括全球性硬化肾小球)中有新月体形成,或在超过30%的剩余肾小球中有节段性坏死或硬化。观察到病理活性与沉积的IgG、IgA和IgM强度(p = 0.01)以及λ链强度(p<0.005)之间存在显著相关性。考虑到蛋白HC的抗炎活性,这些结果表明,由于共沉积的IgG和IgM及/或其他因素,蛋白HC不能充分保护免受急性炎症或组织损伤。(摘要截短至250字)