SERUM IGA-FIBRONECTIN AGGREGATES IN PATIENTS WITH IGA NEPHROPATHY AND HENOCH-SCHONLEIN PURPURA - DIAGNOSTIC-VALUE AND PATHOGENIC IMPLICATIONS

被引:40
作者
JENNETTE, JC
WIESLANDER, J
TUTTLE, R
FALK, RJ
机构
[1] UNIV N CAROLINA,SCH MED,DEPT MED,CHAPEL HILL,NC 27599
[2] BIOCARB DIAG,LUND,SWEDEN
关键词
IGA NEPHROPATHY; FIBRONECTIN; GLOMERULONEPHRITIS; HENOCH-SCHONLEIN PURPURA; IMMUNE COMPLEXES;
D O I
10.1016/S0272-6386(12)80115-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
IgA nephropathy is a common form of glomerulonephritis that has varied clinical expressions, ranging from asymptomatic hematuria to rapidly progressive nephritis. We report the strong association (P < 0.0001) of circulating IgAfibronectin aggregates with IgA nephropathy. Of 30 patients with IgA nephropathy, 93.3% had serum IgA-fibronectin aggregates detected with an enzyme immunoassay using collagen as a substrate to bind the aggregates. Among the patients with IgA-fibronectin aggregates were patients with Henoch-Schonlein purpura and recurrent crescentic IgA nephropathy in transplants. Only 11.7% of 103 patients with other types of glomerular disease and 6.7% of normal controls had positive IgA-fibronectin aggregate assay levels. IgA-fibronectin aggregates also were detected in serum using an antifibronectin antibody capture assay; and could be depleted from serum by heparin-agarose affinity chromatography. The circulating IgA-fibronectin aggregates had the same unusual predominance of λ relative to κ light chains that is observed in the glomerular deposits of IgA nephropathy. The data indicate that IgA-fibronectin aggregates are a useful serologic marker for IgA nephropathy, Henoch-Schönlein purpura, and recurrent IgA nephropathy in transplants. The presence of fibronectin in the circulating aggregates may play an important role in the preferential deposition of nephritogenic IgA-containing immune complexes in the mesangium of patients with IgA nephropathy. © 1991, National Kidney Foundation, Inc.. All rights reserved.
引用
收藏
页码:466 / 471
页数:6
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