类风湿因子与肾小球肾炎。
Rheumatoid factors and glomerulonephritis.
作者信息
Miyazaki M, Endoh M, Suga T, Yano N, Kuramoto T, Matsumoto Y, Eguchi K, Yagame M, Miura M, Nomoto Y
机构信息
Department of Internal Medicine, School of Medicine, Tokai University, Kanagawa, Japan.
出版信息
Clin Exp Immunol. 1990 Aug;81(2):250-5. doi: 10.1111/j.1365-2249.1990.tb03326.x.
It is presently unknown whether rheumatoid factors have a pathogenic role in the development of various types of glomerulonephritis with immune deposits. Three isotypes of rheumatoid factors (RFs), which are autoantibodies to IgG, were measured using the solid-phase fluorescence immunoassay in sera from patients with diffuse proliferative lupus nephritis (DPLN), membranous lupus nephritis (MLN), IgA nephropathy (IgAN) and idiopathic membranous nephropathy (MN). RF activity of immunoglobulins deposited in the glomeruli from these patients was also studied by examining the binding of the FITC-conjugated human IgG and Fc portion of IgG to the glomeruli of renal biopsy specimens. IgG, IgA and IgM RFs were significantly increased in sera from patients with DPLN, and the increase was significantly lower in patients with MLN, IgAN and MN. Human IgG bound to immunoglobulin on the glomeruli only in DPLN, but not in MLN, IgAN or MN. The Fc portion of IgG was demonstrated to be involved in this reaction. It was suggested that RFs and IgG may play a major role in immune deposits on the glomeruli in DPLN and may be involved in the development of DPLN; however, this is not likely in MLN, IgAN or MN.
目前尚不清楚类风湿因子在各类伴有免疫沉积物的肾小球肾炎的发展过程中是否具有致病作用。使用固相荧光免疫测定法，对弥漫性增殖性狼疮性肾炎（DPLN）、膜性狼疮性肾炎（MLN）、IgA肾病（IgAN）和特发性膜性肾病（MN）患者血清中的三种类风湿因子（RFs）同型抗体（针对IgG的自身抗体）进行了检测。通过检测异硫氰酸荧光素（FITC）标记的人IgG及其IgG的Fc部分与肾活检标本肾小球的结合情况，对这些患者肾小球中沉积的免疫球蛋白的RF活性也进行了研究。DPLN患者血清中的IgG、IgA和IgM RFs显著升高，而MLN、IgAN和MN患者的升高幅度明显较低。人IgG仅在DPLN患者的肾小球中与免疫球蛋白结合，而在MLN、IgAN或MN患者中则不结合。已证实IgG的Fc部分参与了这一反应。提示RFs和IgG可能在DPLN患者肾小球免疫沉积物中起主要作用，并可能参与DPLN的发病过程；然而，在MLN、IgAN或MN患者中情况可能并非如此。
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