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한국인 IgA ( Immunoglobulin A ) 신병증 환자에서 IgA 아형에 관한 연구 |
노정우 , 이건용 , 김근호 , 전노원 , 이여천 , 채동완 , 고영혜 , 박문향 |
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Abstract |
IgA nephropahy is characterized by IgA deposition in the renal mesangivm pathologically and by recurring episodes of hematuria clinically. It has been known that not small numbers of cases tend to progress to end stage renal failure slowly. It was suggested that the mesangial IgA deposits might be derived from circulating antigen- IgA class antibody immune-complexes, although the precise mechanisms responsible for the glomerular deposition of IgA remain to be elucidated. It is well known that there are two subclasses of IgA, IgA, and IgA,. The main subclass of IgA deposited in the glomeruli of patients with IgA nephropathy has not been confirmed yet. But recently, IgA has been considered as a domi- nant subclass of IgA by many investigators. Differences of specificity among ant-IgA subclass antibodies, differ- ences in methodology and racial differences have been regarded as main causes of this controversy. Authors, for the first time in Korea, tried direct immunofluores- cent staning to study subclasses of IgA deposited in 67 Korean patients with IgA nephropathy using three anti- IgA, antibodies, a jacalin which is known to bind IgA, specifically and a anti-IgA, antibody. All cases were positive to anti-IgA antibody. With regard to positive ratio by three anti-IgA, antibodies (designated as A, B, C), 23 among 29 cases (79.3%) were positive to anti-IgA, antibody A, but 40 among 45 cases (88.9%) and 0 among 45 cases were positive to other anti-IgA, antibodies B and C, respectively. 64 among 67 cases (95.6%) were positve to jacalin which is also known to bind IgA,. From the above resutls, authors reconfirmed that differences of specificity among antibodies could be one cause of the controversy regarding dominant subclass of IgA deposited in IgA nephropathy and found that IgA, should be the dominant subclass of IgA deposited in the glomeruli of patients with IgA nephropathy in Korea. There was no deposition of IgA, at all in the glomeruli of Korean IgA pitients included in this study. |
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