Tomino Y, Nomoto Y, Sakai H
Department of Internal Medicine, School of Medicine, Tokai University.
Tokai J Exp Clin Med. 1988 Aug;13(3):137-43.
A study of immunofluorescence of unfractionated Type IV collagen, non-collagenous (NC-1) domain of Type IV collagen, basement membrane (GBM) component detected by Goodpasture's syndrome patient's serum and laminin (LN) in the glomeruli from 10 patients with IgA nephropathy was described. Type IV collagen, non-collagenous (NC-1) domain of Type IV collagen, GBM component or LN was observed linearly in the glomerular capillary walls in all patients with IgA nephropathy examined. The deposition of IgA, IgM or C3 was marked in the glomerular capillary walls in patients in the moderate or advanced stage of IgA nephropathy. However, the staining of Type IV collagen, GBM component or LN in such walls was not altered by the depositions of IgA, IgM and C3. In particular, a wrinkled pattern of NC-1 domain of Type IV or GBM component was detected in the glomerular capillary walls of totally sclerotic glomeruli in some patients with IgA nephropathy. It appears that the deposits of IgA and/or C3 did not influence the major components of glomerular capillary walls in patients with IgA nephropathy. It is concluded that the initiating factors of the collapse and/or sclerosis of glomerular capillary walls might be due to various factors other than the deposition of glomerular IgA-dominant immune-complexes in patients with IgA nephropathy.
描述了一项对10例IgA肾病患者肾小球中未分级IV型胶原、IV型胶原的非胶原(NC-1)结构域、由Goodpasture综合征患者血清检测的基底膜(GBM)成分和层粘连蛋白(LN)进行免疫荧光的研究。在所有接受检查的IgA肾病患者的肾小球毛细血管壁中均观察到IV型胶原、IV型胶原的非胶原(NC-1)结构域、GBM成分或LN呈线性分布。在IgA肾病中重度或晚期患者的肾小球毛细血管壁中,IgA、IgM或C3的沉积明显。然而,IgA、IgM和C3的沉积并未改变此类壁中IV型胶原、GBM成分或LN的染色。特别是,在一些IgA肾病患者完全硬化肾小球的肾小球毛细血管壁中检测到IV型或GBM成分的NC-1结构域呈皱缩模式。看来,IgA和/或C3的沉积并未影响IgA肾病患者肾小球毛细血管壁的主要成分。得出的结论是,IgA肾病患者肾小球毛细血管壁塌陷和/或硬化的起始因素可能是除肾小球IgA为主的免疫复合物沉积之外的各种因素。