Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
Am J Pathol. 2012 Oct;181(4):1338-47. doi: 10.1016/j.ajpath.2012.06.038. Epub 2012 Aug 5.
The pathogenic roles of glomerular deposition of components of the complement cascade in IgA nephropathy (IgAN) are not completely clarified. To investigate the pathologic role of complement pathways in IgAN, two IgAN-prone mouse models were examined. Grouped ddY (gddY) mice showed significant high proteinuria, severe glomerular lesions, and extracellular matrix expansion compared with high serum IgA (HIGA) mice but with similar intensity of glomerular IgA deposition. Glomerular activation of the classical, lectin, and alternative pathways was demonstrated by significantly stronger staining for complement (C)3, C5b-9, C1q, C4, mannose-binding lectin (MBL)-A/C, MBL-associated serine protease-2, and factor B and properdin in gddY mice than in HIGA mice. Similarly, the serum levels of IgA-IgG2a/IgM and IgA-MBL-A/C immune complexes and polymeric IgA were significantly higher in gddY mice than in HIGA mice. Moreover, the serum levels of aberrantly glycosylated IgA characterized by the binding of Sambucus nigra bark lectin and Ricinus communis agglutinin I were significantly higher in gddY mice than in HIGA mice. This aberrancy in glycosylation was confirmed by monosaccharide compositional analysis of purified IgA using gas-liquid chromatography. This study is the first to demonstrate that aberrantly glycosylated IgA may influence the formation of macromolecular IgA including IgA-IgG immune complexes and subsequent complement activation, leading to full progression of IgAN.
补体级联成分在 IgA 肾病(IgAN)中的肾小球沉积的致病作用尚不完全清楚。为了研究补体途径在 IgAN 中的病理作用,我们研究了两种 IgAN 易感小鼠模型。与高血清 IgA(HIGA)小鼠相比,ddY 分组(gddY)小鼠表现出明显的大量蛋白尿、严重的肾小球病变和细胞外基质扩张,但肾小球 IgA 沉积的强度相似。通过对补体(C)3、C5b-9、C1q、C4、甘露聚糖结合凝集素(MBL)-A/C、MBL 相关丝氨酸蛋白酶-2 和因子 B 和properdin 的染色,显示 gddY 小鼠的经典、凝集素和替代途径的肾小球激活明显更强。同样,gddY 小鼠的血清 IgA-IgG2a/IgM 和 IgA-MBL-A/C 免疫复合物和聚合 IgA 水平明显高于 HIGA 小鼠。此外,gddY 小鼠血清中异常糖基化 IgA 的水平,其特征是与接骨木树皮凝集素和蓖麻凝集素 I 的结合,明显高于 HIGA 小鼠。通过使用气相色谱-液相色谱对纯化 IgA 进行单糖组成分析,证实了这种糖基化异常。这项研究首次表明,异常糖基化 IgA 可能影响包括 IgA-IgG 免疫复合物在内的大分子 IgA 的形成,以及随后的补体激活,导致 IgAN 的完全进展。