Onda Kisara, Ohi Hiroyuki, Tamano Mariko, Ohsawa Isao, Wakabayashi Michiro, Horikoshi Satoshi, Fujita Teizo, Tomino Yasuhiko
Division of Nephrology, Department of Internal Medicine, School of Medicine, Juntendo University, Tokyo, Japan.
J Clin Lab Anal. 2007;21(2):77-84. doi: 10.1002/jcla.20154.
IgA nephropathy (IgAN) is the most common form of chronic glomerulonephritis. Although glomerular deposition of complement components is well known, the evidence of serological complement activation in IgAN is inconclusive. We hypothesized that serum levels of complement components and regulatory proteins in patients with IgAN are correlated with its pathogenesis. In the present study we measured complement components in 50 patients with IgAN and 50 healthy volunteers. C5, C1 inhibitor, factor B, C4 binding protein, factor H, and factor I were measured with the use of single radial immunodiffusion. Mannose-binding lectin (MBL) and properdin (P) were measured by enzyme-linked immunosorbent assay (ELISA). The correlations among complements in the sera of patients with clinical gradings for IgAN (i.e., the good prognosis group, relatively good prognosis group, relatively poor prognosis group, and poor prognosis group) were evaluated. CH50, C4, factor B, P, factor I, and factor H were significantly higher in IgAN patients than in healthy controls. There were significant correlations between C5 and C4 binding protein, between C3 and C5, or between C4 and factor B in patients with IgAN. In the poor prognosis group, C4 binding protein was significantly higher than in the other groups of IgAN patients. hypercomplementemia occurs in IgAN and is associated with an increase in complement regulatory protein (CRP). C4 binding protein analyses can be used to predict disease prognosis.
IgA肾病(IgAN)是慢性肾小球肾炎最常见的形式。虽然补体成分在肾小球的沉积已为人熟知,但IgAN中血清补体激活的证据尚无定论。我们推测,IgAN患者血清补体成分和调节蛋白水平与其发病机制相关。在本研究中,我们检测了50例IgAN患者和50名健康志愿者的补体成分。采用单向放射免疫扩散法检测C5、C1抑制物、B因子、C4结合蛋白、H因子和I因子。采用酶联免疫吸附测定(ELISA)法检测甘露糖结合凝集素(MBL)和备解素(P)。评估了IgAN临床分级(即预后良好组、预后相对良好组、预后相对较差组和预后较差组)患者血清中补体之间的相关性。IgAN患者的CH50、C4、B因子、P、I因子和H因子显著高于健康对照组。IgAN患者中,C5与C4结合蛋白之间、C3与C5之间或C4与B因子之间存在显著相关性。在预后较差组中,C4结合蛋白显著高于其他IgAN患者组。IgAN中出现补体血症升高,且与补体调节蛋白(CRP)增加有关。C4结合蛋白分析可用于预测疾病预后。