Mansfield L E, Trygstad C W, Ajugwo R E, Heiner D C
J Allergy Clin Immunol. 1980 Sep;66(3):227-32. doi: 10.1016/0091-6749(80)90044-5.
Serum concentrations of IgE, IgG, and alpha 2-macroglobulin (alpha 2-M) were determined in 67 children with renal disease and in appropriate controls. IgE concentrations were significantly elevated in patients with renal disease and proteinuria, including those with minimal change nephrotic syndrome (MCNS). IgG concentrations were lower and alpha 2-M concentrations higher in patients with proteinuria than in patients without proteinuria. In 16 patients with nephrotic syndrome who had a decrease in proteinuria with therapy, there was a concomitant decrease in mean serum IgE level. All nine with MCNS had a decrease in serum IgE following therapy whereas eight of the nine had a concomitant increase in serum IgG. The findings suggest the possibility that IgE may play an etiologic role in the proteinuria of childhood nephrotic syndrome, and that both elevated serum IgE and proteinuria may represent unusual responses to antigens that are seldom identified. Elevations of IgE secondary to lowered IgG or to entirely nonspecific alterations in IgE metabolism in proteinuric renal disease are other possibilities. Further studies to elucidate the role of IgE in renal disease, including the nature of the altered metabolism of this immunoglobulin, are warranted.
测定了67例肾病患儿及相应对照组血清中IgE、IgG和α2-巨球蛋白（α2-M）的浓度。肾病伴蛋白尿患者，包括微小病变肾病综合征（MCNS）患者，其IgE浓度显著升高。有蛋白尿患者的IgG浓度低于无蛋白尿患者，而α2-M浓度则高于无蛋白尿患者。在16例经治疗蛋白尿减少的肾病综合征患者中，血清IgE平均水平也随之下降。所有9例MCNS患者治疗后血清IgE均下降，而9例中有8例血清IgG同时升高。这些发现提示，IgE可能在儿童肾病综合征蛋白尿的病因中起作用，血清IgE升高和蛋白尿可能都是对很少能明确的抗原的异常反应。IgE升高继发于IgG降低或蛋白尿性肾病中IgE代谢完全非特异性改变也是有可能的。有必要进行进一步研究以阐明IgE在肾病中的作用，包括这种免疫球蛋白代谢改变的性质。
