Orfila C, Rakotoarivony J, Manuel Y, Suc J M
INSERM U 133, Faculté de Médecine, Toulouse, France.
Virchows Arch A Pathol Anat Histopathol. 1988;412(6):591-4. doi: 10.1007/BF00844295.
Renal tissue from 185 patients with various nephropathies were studied by immunofluorescence, in order to look for the frequency and potential predominance of kappa or lambda light chain glomerular deposits. Four normal renal biopsies were used as controls. An overall study shows that light chains were present in glomeruli in 136 out of 185 cases; kappa light chain deposits were more frequent than lambda light chain deposits (73.5% and 64.3% respectively). An analytical study shows that this was not observed in all nephropathies studied. In mesangial IgA nephropathy, lambda light chain deposits were seen in 81% of cases (29 out of 37) and kappa light chain deposits were observed in 78% (30 out of 37 cases). In lupus nephritis, lambda light chain deposits were present in 13 out of 14 cases (92.8%) whereas kappa light chain deposits were demonstrated in 12 cases (85.7%). In other nephropathies such as membranous, endocapillary proliferative and amyloid nephritis, kappa was the predominant light chain observed in glomeruli or was present in the same number of cases as lambda light chain (mesangiocapillary glomerulonephritis). These findings show that in certain nephritides, for example IgA nephropathy and lupus nephritis, IgA and IgG deposits are mainly composed of lambda light chain in contrast with the normal kappa: lambda ratio in human serum of 2:1.
为了探寻κ或λ轻链肾小球沉积物的频率及潜在优势，对185例患有各种肾病患者的肾组织进行了免疫荧光研究。选取4例正常肾活检组织作为对照。总体研究显示，185例中有136例肾小球存在轻链；κ轻链沉积物比λ轻链沉积物更常见（分别为73.5%和64.3%）。分析研究表明，并非在所有研究的肾病中都观察到这种情况。在系膜IgA肾病中，81%的病例（37例中的29例）可见λ轻链沉积物，78%（37例中的30例）观察到κ轻链沉积物。在狼疮性肾炎中，14例中有13例（92.8%）存在λ轻链沉积物，12例（85.7%）显示有κ轻链沉积物。在其他肾病如膜性肾病、毛细血管内增生性肾炎和淀粉样变性肾炎中，κ是在肾小球中观察到的主要轻链，或与λ轻链出现的病例数相同（系膜毛细血管性肾小球肾炎）。这些发现表明，在某些肾病中，例如IgA肾病和狼疮性肾炎，与人类血清中正常的κ:λ比例2:1相反，IgA和IgG沉积物主要由λ轻链组成。
