Immunofluorescent localization of immunoglobulins, complement, and fibrinogen in human diseases. II. Acute, subacute, and chronic glomerulonephritis.

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Abstract
Kidneys from 17 patients with acute, subacute and chronic glomerulonephritis were examined by the fluorescent antibody technique to assess: the type of immunoglobulin (gamma2, gamma1M, or gamma1A globulin) and its relation to complement localization, and the significance of fibrinogen deposition. Gamma2 and gammalM globulins were demonstrated in glomeruli in all stages of glomerulonephritis. These proteins appeared to be deposited in a diffuse membranous fashion throughout the glomerulus, and they could be partially eluted by acid buffer. In subacute glomerulonephritis glomeruli were stained with greater frequency and intensity than in chronic glomerulonephritis. GammalA globulin was present in tubular epithelium in the absence of complement. Complement was deposited in renal glomeruli in a pattern similar to gamma2 and gammalM globulins. Membranous and interstitial deposition of fibrinogen in glomeruli and diffuse localization in some crescents were observed in subacute and chronic glomerulonephritis. Histochemical stains for fibrin revealed rare focal fibrin deposits in glomeruli but never a membranous distribution. The striking similarity of the immunoglob- ulin, complement, and fibrinogen localization in patients with glomerulonephritis and systemic lupus erythematosus may imply a common immunologic pathogenesis. Differences in the antigenic moieties of the immune complexes and in the intensity of the antibody response to these antigens may be reflected in the more prolonged course of chronic glomerulonephritis. Fibrinogen deposition may contribute to the process of glomerulosclerosis.