Kloster Smerud H, Fellström B, Hällgren R, Osagie S, Venge P, Kristjánsson G
Departments of Nephrology, Uppsala University Hospital, Uppsala, Sweden.
Clin Nephrol. 2010 Nov;74(5):364-71. doi: 10.5414/cnp74364.
sensitivity to food antigens has been postulated as a contributing factor to the pathogenesis of IgA nephropathy (IgAN).
in this study we used a recently developed mucosal patch technique to evaluate rectal mucosal sensitivity to soy and cow's milk (CM) proteins in IgAN patients (n = 28) compared to healthy subjects (n = 18). The rectal mucosal production of nitric oxide (NO) and release of myeloperoxidase (MPO) and eosinophil cationic protein (ECP) were measured. Serum samples were analyzed for IgA and IgG antibodies to alpha-lactalbumin, beta-lactoglobulin, casein and soy.
14 of 28 (14/28) patients experienced a rectal mucosal reaction, measured by increased NO and/or MPO levels, upon rectal challenge with soy and/or cow's milk proteins. The levels of IgG antibodies to alpha-lactalbumin, beta-lactoglobulin and casein were significantly higher in CM sensitive as compared with non-sensitive IgAN patients, whereas the mean serum levels of IgA antibodies were similar. No differences were seen in serum levels of IgA or IgG antibodies to soy.
it is concluded that approximately half of our IgAN patients have a rectal mucosal sensitivity to soy or CM, and that an immune reactivity against antigens may be involved in the pathogenesis of IgAN in this subgroup of patients.
食物抗原敏感性被认为是IgA肾病（IgAN）发病机制的一个促成因素。
在本研究中，我们使用一种最近开发的黏膜贴片技术，评估28例IgAN患者与18例健康受试者对大豆和牛奶（CM）蛋白的直肠黏膜敏感性。测量直肠黏膜一氧化氮（NO）的产生以及髓过氧化物酶（MPO）和嗜酸性粒细胞阳离子蛋白（ECP）的释放。分析血清样本中针对α-乳白蛋白、β-乳球蛋白、酪蛋白和大豆的IgA和IgG抗体。
28例患者中有14例（14/28）在直肠用大豆和/或牛奶蛋白激发后，出现直肠黏膜反应，通过NO和/或MPO水平升高来衡量。与非敏感性IgAN患者相比，CM敏感患者中针对α-乳白蛋白、β-乳球蛋白和酪蛋白的IgG抗体水平显著更高，而IgA抗体的平均血清水平相似。大豆的IgA或IgG抗体血清水平未见差异。
得出的结论是，我们大约一半的IgAN患者对大豆或CM有直肠黏膜敏感性，并且在该亚组患者中，针对抗原的免疫反应性可能参与了IgAN的发病机制。
