UP (2) Table 1 Clinicopathologic findings of 30 patients with membranous glomerulonephritisa : urinary protein, IF : immunofluorescence findings Fib.:
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1 Search fcr Renal Tubular Epithelial Antigen in Membranous Glomerulonephritis. YOSHIAKI OHTA, AKIO KOYAMA, HIROMI INAGE MITSUHARU NARITA and SHIZUO TOJO. Institute of Clinical Medicine, The University of Tsukuba, Ibaraki, Japan. Key words: membranous glomerulonephritis, immune complex (IC), renal tubular epithelial (RTE) antigen, glomerular immune deposit, circa ating anti- RTE antibody In order to confirm a pathogenic role of renal tubular epithelial (RTE) antigen i n membranous glomerulonephritis, we searched for RTE antigens and anti-rte antibodies in membranous glomerulonephritis patients. RTE antigens were prepared from normal kidneys by a techniq ue adapted from that of Edgington et al. and Naruse et al. Biopsies from 30 patients with membranous glomerulonephritis (22 patients with primary membranous glomerulonephritis and 8 patients with secondary membranous glomerulonephritis) were examined for the presence of RTE antigens in glomerular immune deposits. In no instance was RTE antigen in glomerular immune deposits. Collected sere from 18 patients with membranous glomeru lonephritis (11 patients with primary membranous glomerulonephriti s and 7 patients with secondary membranous glomerulonephritis) were assayed for a nti-rte antibodies by indirect im:inunofluorescence and by radioimmunodiffusion. However, they had no demonstrable circulating anti-rte antibody. T hese studies suggest that if RTE antigen posseses a nephritogenic p otential for human membranous glomerulonephritis, it is probably only rarely expressed.
2 UP (2) Table 1 Clinicopathologic findings of 30 patients with membranous glomerulonephritisa : urinary protein, IF : immunofluorescence findings Fib.: fibrinogen, (gold) : gold therapy RVT: renal vein thrombosis, DM : diabetes mellitus RA : rheumatoid arthritis, SLE : systemic lupus erythematosus
3 Table 2 Clinical and laboratortory data for 18 patients with membranous glomerulonmephritis.
4 Fig. 1 Characterization of RTE antigen. An arrow shows RTE antigen (a zone)
5 日腎誌 第XXⅣ 巻 を 密 着Lautoradiographyを 1393 大田義章他 4名 第11号1984 施 行 して 検 索 した く,抗RTE抗 体(家兔IgG)と 抗 家兔IgGI血清 間 て 形 成 さ れ る 沈 降 線 に一 致し てI標 結 1) RTE抗原の plateに 果 に よ る 感 光(Fig.3で 性状 の 検 討:RTE抗 よ る 電 気 泳 動 上,α 原 はagar gel 領 域 に あ り(Fig.1),radioi- mmunoelectrophoresisに よ る 検 討 で は ヒ ト血 清 成 分は る 険 討:ヒ 抗RTE抗 3)腎切片GBM上 borderに 的 に 螢 光 染 色 さ れ た が,糸 位 尿細 管 さ ら に,こ は 染 色 は み ら れ な か っ た (2)酸 体 に よ る 螢 光 染 色 で は,IgGに の抗 原 光染 に よ る 検 討:Fig.3 の ごと 対 す る 染 色 は 減 弱し,(1) はRTE抗 原 は 認 め ら れ な か っ た 4)患 者 血 清 中 の 抗RTE抗 Section RTE of normal antigen. proximal tubular capillary walls. human Specific 体 法 に よ る抗RTE抗 kidney stained Iluorescence epithelial cells. 識 抗RTE抗 に は 染 色 は み ら れ な か っ た じ 以 上 よ り腎 切片GBMに 色 は 消 失 した 2 処理 に よ と 同 様 に 全 例 で 尿 細 管 上 皮 の 染 色 は み ら れ た が,GBM 体 を 吸 収 した と こ ろ,螢 (2)R adioimmunodiffusion法 記 対像 患者全 の 尿細 管 上 皮 は 染 色 され り抗 原 抗 体 を 解 離 溶 出 した 後 のFITC標 球 体 お よ び 腎 の 他 の 部 分 には 識 抗RTE抗 原 の 検 索:(1)FITC 体 に よ る 螢 光 染 色 で は,上 た が,GBMに 相 当 す る 部 分 のみ が特 異 螢 光 染 色 は み られ な か っ た(Fig.2) Fig. のRTE抗 例 で 正 常 腎 と 同 様 に 腎切片上 ト正 常 腎 ク リオ ス タ ッ ト切 片 のFITC標識 上皮 管 腔 側 のbrush でFITC標 光抗体 法 に よ 体 の 直 接 法 に よ る 螢 光 染 色 で は,近 認 め られ た が, 常 家 兎 血 清 では 沈 降 線上 に 感光は 標 識 抗RTE抗 体 の 性 状 の 検 討:(1)螢 原 認 め ら れ な かった 検 出 さ れ な か っ た 2)抗RTE抗 識RTE抗 矢 印 が 示 す)が negative eontrolの正 との with is observed No (5) fluorescence 体 の 検 索:(1)間 体 の 検 索:上 FITC-conjugated only in is found the on 記 対 象 患者 全 例 で. antibody luminal the 接螢 光抗 layer glomerular to of
6 1394 膜性糸球体腎炎における腎尿細管上皮抗原の関与につ いての検討 Fig. Fig. 3 4 Radioimmunodiffusion of RTE antigen and -RTE antigens on precipitation lines Radioimmunologic antigens search on precipitation for circulating lines. (6) anti-rte anti-rte antibody, antibody. Arrows Arrows show I 125I-RTE
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8 2) Whitworth, J. A., Leibowitz, S., Kennedy, M. C., Cameron, J. S., Evans, D. J., Glasslock, R. J. and Schoenf eld, L. S.: Absence of glomerular renal tubular epithelial antigen in membranous glomerulonephritis. Gun. Nephrol., 5: , ) Zager, R. A., Couser, W, G., Andrews, B. S., Bolton, W. K. and Pohl, M. A.: Membranous nephropathy: A radioimmunologic search for antirenal tubular epithelial antibodies and circulating immune complexes. Nephron, 24: 10-16, ) Thorpe, L. W. and Cavallo, T.: Renal tubule brush border antigens: Failure to confirm a pathogenic role in human membranous glomerulonephritis. J. Gun. Lab. Immunol., 3: , ) Collins, A. B., Giuseppe, A. A. and McCluskey, R. T.: Lack of evidence for a role of renal tubular antigen in human membranous glomerulonephritis. Nephron, 27: , ) Edgington, T. S., Glassock, R. J., Watson, J. I. and Dixon, F. J.: Characterization and isolation of specific renal tubular epithelial antigens. J.
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β1イ ン テ グ リン お よ び フ ィ ブ ロ ネ ク チ ンの 局 在 し た メ サ ン ギ ウ ム 基 質 内 にelectron deposit (EDD)を お り, electron dense deposit dense 認 め た(図3). 部 分 に も局 在 して い た.ま 免 疫 電 顕 で は, β1イ ン テ グ リ ン は メサ ン ギ ウ 正 常 腎 お よ び
More informationAmer. J. Path., 46 : 387-401, 1965. 6) Sherlock, S. & Scheuer, P. J.: The presentation and diagnosis of 100 patients with primary biliary 8) Kimmelstiel, P.: Diabetic nephropathy. In Bec 1968, p 462. 9)
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