Takahara Miki, Kishibe Kan, Nozawa Hayabusa, Harabuchi Yasuaki
Departments of Otolaryngology-Head and Neck Surgery, Asahikawa Medical College, Asahikawa, Japan.
Acta Otolaryngol Suppl. 2004 Dec(555):25-7. doi: 10.1080/03655230410003341.
It is known that IgA nephropathy (IgAN) often progresses to end-stage renal failure within a period of 20 years. There are many reports suggesting the relationship between the tonsillar autoimmune response and the pathogenesis of IgA nephropathy, however, definitive evidence has not been detected. Recently, studies of T-cell receptor variable (TCR V) region gene usage in human autoimmune disease showed that the TCR V beta repertoire of pathogenic T cells was highly restricted. In this study, we examined expression of TCR V beta families in tonsils from IgAN patients. The study group consisted of 7 IgAN patients and 7 obstructive sleep apnea syndrome (OSAS) patients. Total RNA was extracted from the tonsils of each patients, and expression of each TCR V beta subfamily gene were examined by reverse transcription-polymerase chain reaction (RT-PCR) method. V beta 6 is more frequently used in tonsils of IgAN patients than in those of OSAS patients (p = 0.01), and V beta 20 is more frequently used in OSAS patients than IgAN patients (p =0.01). It was already reported that the frequency of V beta 6 subfamily usage is elevated in both peripheral blood lymphocytes (PBL) and renal tissues of IgAN patients Therefore, our results suggested that the tonsils may be one of the sources of specific T cells related to the pathogenesis of IgAN.
已知IgA肾病（IgAN）常在20年内进展为终末期肾衰竭。有许多报告提示扁桃体自身免疫反应与IgA肾病发病机制之间的关系，然而，尚未发现确凿证据。最近，对人类自身免疫性疾病中T细胞受体可变（TCR V）区基因使用情况的研究表明，致病性T细胞的TCR Vβ谱系受到高度限制。在本研究中，我们检测了IgAN患者扁桃体中TCR Vβ家族的表达。研究组由7例IgAN患者和7例阻塞性睡眠呼吸暂停综合征（OSAS）患者组成。从每位患者的扁桃体中提取总RNA，并用逆转录-聚合酶链反应（RT-PCR）方法检测各TCR Vβ亚家族基因的表达。Vβ6在IgAN患者扁桃体中的使用频率高于OSAS患者（p = 0.01），而Vβ20在OSAS患者中的使用频率高于IgAN患者（p = 0.01）。已有报道称，IgAN患者外周血淋巴细胞（PBL）和肾组织中Vβ6亚家族的使用频率均升高。因此，我们的结果提示扁桃体可能是与IgAN发病机制相关的特异性T细胞的来源之一。
