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人类肾脏疾病中肾小球沉积物的γ-G球蛋白亚群组成

Gamma G globulin subgroup composition of the glomerular deposits in human renal diseases.

作者信息

Lewis E J, Busch G J, Schur P H

出版信息

J Clin Invest. 1970 Jun;49(6):1103-13. doi: 10.1172/JCI106326.

Abstract

36 renal biopsies from patients with nephritis were studied for glomerular localization of the heavy chain subgroups of immunoglobulin G (IgG or gammaG). The deposition pattern of these subgroups was selective and did not reflect the normal serum concentration of these proteins. gammaG2, which comprises 18% of normal serum gammaG, was the predominant or unique subgroup deposited in five cases of lupus nephritis and four biopsies with other forms of nephritis associated with granular gammaG deposits. gammaG3, which normally makes up only 8% of the serum gammaG, was the dominant subgroup seen in one biopsy of lobular glomerulonephritis. Patients with linear gammaG deposits generally had a selective absence of gammaG3 and often had large amounts of gammaG4 (normally 3% of the serum gammaG) deposited. The deposition of complement components C1q, C4, and C3 was variable. One biopsy had only gammaG2 and no complement components in the deposits and had no neutrophile leukocyte infiltration. This latter observation correlates well with the poor ability of gammaG2 to fix complement in vitro. Similarly, deposits containing large amounts of gammaG4, which does not fix complement, also tended to have less inflammatory infiltrate than deposits devoid of this subgroup. The selective deposition of monotypic or restricted gammaG subgroups on the glomerulus supports the likelihood that the gammaG represents antibody. The nature of the subgroup involved in the deposit may represent one variable in the determination of the inflammatory and morphological picture that evolves in human glomerulonephritis.

摘要

对36例肾炎患者的肾活检组织进行研究,以观察免疫球蛋白G(IgG或γG)重链亚群在肾小球中的定位。这些亚群的沉积模式具有选择性,并不反映这些蛋白质的正常血清浓度。γG2在正常血清γG中占18%,是5例狼疮性肾炎及4例伴有颗粒状γG沉积的其他形式肾炎活检组织中的主要或唯一沉积亚群。γG3在正常血清γG中仅占8%,是小叶性肾小球肾炎1例活检组织中的主要亚群。线性γG沉积的患者通常选择性缺乏γG3,且常有大量γG4(正常时占血清γG的3%)沉积。补体成分C1q、C4和C3的沉积情况各不相同。1例活检组织的沉积物中仅有γG2,无补体成分,也无中性粒细胞浸润。后一观察结果与γG2在体外固定补体能力较差密切相关。同样,含有大量不固定补体的γG4的沉积物,其炎症浸润也往往比不含该亚群的沉积物少。单一型或受限的γG亚群在肾小球上的选择性沉积支持了γG代表抗体的可能性。沉积物中所涉及亚群的性质可能是决定人类肾小球肾炎中炎症和形态学表现的一个变量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ae/322578/e35526069b8c/jcinvest00222-0076-a.jpg

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