Shinkai Y, Karai M, Osawa G, Sato M, Koshikawa S
Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
Nephron. 1990;56(3):285-96. doi: 10.1159/000186156.
IgG, IgA and IgM class antibodies to mouse laminin and human fibronectin in sera from patients with various glomerular diseases (50 cases of IgA nephropathy, 5 cases of minimal-change nephrotic syndrome; 6 cases of membranous nephropathy, 5 cases of systemic lupus erythematosus, 2 cases of Henoch-Schönlein purpura, 3 cases of poststreptococcal nephritis and 4 cases of preeclampsia) and from 30 normal controls were tested using a solid-phase enzyme-linked immunosorbent assay method. IgA antimouse laminin antibody titers in sera from IgA nephropathy patients were significantly higher (p less than 0.05) than in controls. There were no statistical differences in IgA antimouse laminin antibody titers between patients with other glomerular diseases and normal controls. IgM antimouse laminin antibody was significantly raised (p less than 0.01) in sera from patients with preeclampsia. The reaction of mouse laminin with the IgA nephropathy and preeclampsia sera on each of the IgA and IgM assay systems was inhibited by the antigen at up to 5 micrograms/ml. However, it was not inhibited by anti-C3d, anti-C1q, anti-J chain and antisecretory component sera or saccharides. The reaction of mouse laminin with an exceptionally high-titer IgA antimouse laminin antibody serum from a normal control on the IgA assay system was clearly inhibited by 1 mM of melibiose, which contains alpha-galactosyl residues. The same concentration of melibiose, however, did not inhibit the reaction of mouse laminin with IgA nephropathy sera on the same assay system. Treatment of mouse laminin with alpha-galactosidase did not alter any binding from IgA nephropathy sera but binding was lost from an exceptionally high-titer normal control serum. There were no correlations between serum IgA level and IgA antimouse laminin antibody titer in sera from IgA nephropathy patients. Immunoblot techniques revealed the presence of antibody in sera from IgA nephropathy patients reacting with both subunits A and B of laminin, somewhat stronger with laminin A. None of the sera tested contained antifibronectin antibodies. These results indicate that the IgA antimouse laminin antibody is a specific antibody in IgA nephropathy and might play a role in the pathogenesis of the nephritis since mouse laminin and human mesangial laminin present a common epitope.
采用固相酶联免疫吸附测定法,检测了各类肾小球疾病患者(50例IgA肾病、5例微小病变肾病综合征、6例膜性肾病、5例系统性红斑狼疮、2例过敏性紫癜、3例链球菌感染后肾炎和4例先兆子痫)以及30名正常对照者血清中针对小鼠层粘连蛋白和人纤连蛋白的IgG、IgA和IgM类抗体。IgA肾病患者血清中抗小鼠层粘连蛋白抗体滴度显著高于对照组(p<0.05)。其他肾小球疾病患者与正常对照者的抗小鼠层粘连蛋白抗体滴度无统计学差异。先兆子痫患者血清中抗小鼠层粘连蛋白IgM抗体显著升高(p<0.01)。在IgA和IgM检测系统中,抗原浓度高达5微克/毫升时可抑制小鼠层粘连蛋白与IgA肾病和先兆子痫血清的反应。然而,抗C3d、抗C1q、抗J链和抗分泌成分血清或糖类不能抑制该反应。在IgA检测系统中,1毫摩尔的蜜二糖(含有α-半乳糖基残基)可明显抑制小鼠层粘连蛋白与一份正常对照者的高滴度抗小鼠层粘连蛋白IgA抗体血清的反应。然而,相同浓度的蜜二糖在同一检测系统中不能抑制小鼠层粘连蛋白与IgA肾病血清的反应。用α-半乳糖苷酶处理小鼠层粘连蛋白后,IgA肾病血清的结合未改变,但一份高滴度正常对照血清的结合丧失。IgA肾病患者血清中IgA水平与抗小鼠层粘连蛋白抗体滴度无相关性。免疫印迹技术显示,IgA肾病患者血清中存在与层粘连蛋白A和B两个亚基反应的抗体,与层粘连蛋白A的反应稍强。所检测的血清中均未含抗纤连蛋白抗体。这些结果表明,抗小鼠层粘连蛋白IgA抗体是IgA肾病中的一种特异性抗体,可能在肾炎发病机制中起作用,因为小鼠层粘连蛋白和人系膜层粘连蛋白存在共同表位。