IMMUNOLOGICAL ABNORMALITIES IN THE TONSILS OF PATIENTS WITH IGA NEPHROPATHY - INVERSION IN THE RATIO OF IGA-IGG BEARING LYMPHOCYTES AND INCREASED POLYMERIC IGA SYNTHESIS

  • 1 January 1984
    • journal article
    • research article
    • Vol. 57  (1) , 101-106
Abstract
In the last few years the mucosal origin of the IgA deposited in the kidneys of patients with IgA nephropathy was examined by several investigators. Polymeric IgA may have a predominant role in the pathogenesis of IgA nephropathy. Taking into account that these patients often present with macroscopic hematuria following respiratory tract infections, the possible existence of immunological abnormalities was studied in the tonsils of patients with IgA nephropathy. Six patients and 13 controls suffering from chronic tonsillitis were submitted to tonsillectomy. Patients with IgA nephropathy showed a significant increase (P < 0.00025) in IgA bearing lymphocytes (14.4 .+-. 2.3) and a significant decrease (P < 0.025) in IgG bearing lymphocytes (20.5 .+-. 4.6) compared to the control group (2.9 .+-. 1.4 and 31.6 .+-. 3.6, respectively). After 7 days of culture with pokeweed mitogen the percentage of tonsillar cells producing polymeric IgA was significantly higher in the patients than in the controls (66.5 .+-. 12.6 vs. 33.4 .+-. 10.3; P < 0.005). A mucosal origin for the IgA deposited in the kidneys of these patients is suggested. The data are consistent with the existence of an immunoregulatory dysfunction in the secretory immune system of patients with IgA nephropathy.