Itoh Akihiko, Iwase Hitoo, Takatani Toru, Nakamura Ikuko, Hayashi Miyuki, Kobayashi Yutaka, Hiki Yoshiyuki, Okamoto Makito
Department of Otolaryngology, Kitasato University, Sagamihara, Kanagawa--Japan.
J Nephrol. 2005 Sep-Oct;18(5):575-81.
There are reports concerning the relationship between tonsillectomy and immunoglobulin A nephropathy (IgAN). Two reports on the biochemical analysis of over-produced IgA1 from IgAN patients were recently published. On the other hand, histochemical analysis of tonsillar tissue indicated the disordered balance in IgG and IgA producing cells and in the IgA subclass producing cells in IgAN patients.
IgA in tonsillar extracts and serum was separated into passed fraction (IgA2) and bound fraction (IgA1) by a jacalin-agarose column. Isoelectric focusing (IEF) analysis was carried out using an IPGphor instrument. The IgA content in each sample was analyzed by enzyme-linked immunosorbent assay (ELISA).
The IgA1/IgA2 ratio of the tonsillar extracts from controls and IgAN patients was compared. The ratio distribution indicated statistically significant differences. The mean ratio for the control tonsil was 61/39. However, the ratio from eight out of thirty-two IgAN patients exhibited a higher value than the mean + 2SD (standard deviation) of the controls. Among them, three patients exhibited 92/8. Meanwhile, the ratios for serum by this method were close to the previously reported 89/11. There were no differences in the IgA1 IEF profile between the representative lowand high-IgA1 producing patients.
This is the first report concerning IgA subclass distribution in tonsillar tissue. The ratio 61/39 for tonsillar IgA differ from the value (>90% of IgA1) in the previous histochemical report. The value is similar to the previous report for colostrum, whole saliva, jejunal fluid and bronchial fluid. The IgA1/IgA2 ratio distribution in the tonsillar extracts from the patients with chronic tonsillitis is significantly different from that of the IgAN patients.
有关于扁桃体切除术与免疫球蛋白A肾病（IgAN）之间关系的报道。最近发表了两篇关于IgAN患者过量产生的IgA1的生化分析报告。另一方面，扁桃体组织的组织化学分析表明，IgAN患者中产生IgG和IgA的细胞以及产生IgA亚类的细胞的平衡紊乱。
通过红豆蔻凝集素-琼脂糖柱将扁桃体提取物和血清中的IgA分离为通过部分（IgA2）和结合部分（IgA1）。使用IPGphor仪器进行等电聚焦（IEF）分析。通过酶联免疫吸附测定（ELISA）分析每个样品中的IgA含量。
比较了对照组和IgAN患者扁桃体提取物的IgA1/IgA2比值。比值分布显示出统计学上的显著差异。对照扁桃体的平均比值为61/39。然而，32例IgAN患者中有8例的比值高于对照组平均值+2标准差（SD）。其中，3例患者的比值为92/8。同时，用这种方法测得的血清比值接近先前报道的89/11。在代表性的低IgA1产生患者和高IgA1产生患者之间，IgA1的IEF图谱没有差异。
这是关于扁桃体组织中IgA亚类分布的首次报告。扁桃体IgA的61/39比值与先前组织化学报告中的值（>90%为IgA1）不同。该值与先前关于初乳、全唾液、空肠液和支气管液的报告相似。慢性扁桃体炎患者扁桃体提取物中的IgA1/IgA2比值分布与IgAN患者的显著不同。
