Circulating immume complexes and complement breakdown products in childhood IgA nephropathy.
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概要
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Circulating immune complexes (CIC), mainly IgA-CIC have been frequently detected in IgA nephropathy and recently increased levels of C3 fragments which indicate C3 activation have been reported. However, little is known about the relationship between CIC and complement activation. We determined CIC by the solid-phase anti-C3 Facb enzyme immunoassay in 37 children with IgA nephropathy to investigate the relationship between CIC and clinical and/or histological findings, and also determined C3 fragments whether CIC correlate with complement activation. IgA-CIC were detected in 78% (27/ 37) with a mean level of 11.9±3.9 μg/ml, which was significantly higher than other glomerular diseases (P<0.05). IgA-CIC levels were also found significantly higher in 27 cases with proteinuria than in 10 cases without proteinuria (P<0.05). IgG-CIC were detected in 67% (12/18) with a mean level of 4.1±2.6 μg/ml, which was not significantly different from other glomerular diseases. No striking correlation was noted to exist between CIC levels at renal biopsy and the histological severity, because CIC are often present intermittently. C3d was quantitated by the rocket immunoelectrophoresis and C3 by the single radial immunodiff union to determine the C3d/C3 ratio. The mean value of x C3d/C3 was 0.63±0.19 which was significantly higher than a corresponding value for 15 healthy controls of 0.27±0.06 (P<0.05). Levels of IgA-CIC were found to have a sig-nificant positive correlation between C3d/C3 determined simultaneously in 33 cases (r= 0.43, P<0.05). There was also a significant positive correlation between IgG-CIC and C3d/C3 in 18 cases (r=0.60, P<0.05). The Cod/C4 ratio quantitated in 11 cases was increased in only 3 cases, and had no correlation with either of IgA-CIC and IgG-CIC. These results suggest that there is certain activation of alternative complement pathway by CIC in IgA nephropathy, and thus play important roles in the pathogenesis of IgA nephropathy.
- 社団法人 日本腎臓学会の論文
社団法人 日本腎臓学会 | 論文
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