Maggiore Q, Bartolomeo F, L'Abbate A, Misefari V, Martorano C, Caccamo A, di Belgiojoso G B, Tarantino A, Colasanti G
Kidney Int. 1982 Feb;21(2):387-94. doi: 10.1038/ki.1982.34.
Kidney biopsy samples from 27 patients with essential mixed cryoglobulinemia of the IgG-IgM(k) type and glomerulonephritis were studied to assess whether glomerular immunodeposits display antiglobulin (AG) activity similar to that of serum cryo-IgM. A preparation of heat-aggregated human IgG (FAIgG) was used to search for tissue AG activity, and blocking tests and reactivity tests were carried out to define the nature of this activity. Glomerular localization of FAIgG was observed in 17 out of 27 kidney specimens, the positive findings being always associated with IgM deposits. Prior exposure of tissue sections to anti-IgM serum blocked the FAIgG reaction, but no such effect was produced by the pretreatment with other antisera. The positive FAIgG tissue specimens yielded a similar fluorescence pattern with aggregated alkylated-reduced IgG, but did not react at all with the aggregated F(ab')2 or aggregated albumin. The IgM recovered in the eluate of a kidney biopsy specimen displayed AG activity. Patients with AG deposits showed more severe histologic changes and a greater renal functional impairment than did those without. The data support the notion that circulating cryo-IgM anti-IgG participates in the formation of glomerular immunodeposits and in the genesis of renal damage.
对27例IgG-IgM（κ）型原发性混合性冷球蛋白血症合并肾小球肾炎患者的肾活检样本进行研究，以评估肾小球免疫沉积物是否表现出与血清冷IgM相似的抗球蛋白（AG）活性。使用热聚集人IgG（FAIgG）制剂来寻找组织AG活性，并进行阻断试验和反应性试验以确定该活性的性质。在27个肾脏标本中的17个中观察到FAIgG的肾小球定位，阳性结果总是与IgM沉积物相关。将组织切片预先暴露于抗IgM血清可阻断FAIgG反应，但用其他抗血清预处理则没有这种效果。阳性FAIgG组织标本与聚集的烷基化还原IgG产生相似的荧光模式，但与聚集的F（ab'）2或聚集的白蛋白完全不反应。从肾活检标本洗脱液中回收的IgM显示出AG活性。有AG沉积物的患者比没有的患者表现出更严重的组织学变化和更大的肾功能损害。这些数据支持循环冷IgM抗IgG参与肾小球免疫沉积物形成和肾损伤发生的观点。
