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Nephrol Dial Transplant (2000) 15: 619-624
© 2000 European Renal Association-European Dialysis and Transplant Association

Synthesis of immunoglobulins against Haemophilus parainfluenzae by tonsillar lymphocytes from patients with IgA nephropathy

Satoru Suzuki1,, Shigeharu Fujieda2, Hiroshi Sunaga2, Chie Yamamoto1, Hideki Kimura1 and Fumitake Gejyo3

1 Departments of Clinical and Laboratory Medicine and 2 Otorhinolaryngology, Fukui Medical University, Fukui and 3 Department of Medicine (II), Niigata University School of Medicine, Niigata, Japan

Background. We previously demonstrated glomerular deposition of Haemophilus parainfluenzae (HP) antigens and the presence of IgA antibody against HP antigens in patients with IgA nephropathy (IgAN). In this report we examine the synthesis of immunoglobulins against HP antigens in tonsillar lymphocytes from patients with IgAN.

Methods. We used tonsillar lymphocytes isolated from the palatine tonsils of 15 patients with IgAN and 16 patients with chronic tonsillitis but without renal disease. We examined lymphocyte proliferation and production of IgA, IgG, and IgM antibodies against HP antigens by measuring thymidine uptake and concentrations of these antibodies in culture supernatants after lymphocyte incubation with HP antigens by ELISA.

Results. Lymphocytes from patients with IgAN showed a significantly higher stimulation index (SI) on exposure to HP antigens (thymidine incorporation in tonsillar lymphocytes exposed to HP (c.p.m.)/ thymidine incorporation in unstimulated tonsillar lymphocytes (c.p.m.)) than did controls (P=0.0015). Lymphocytes from patients with IgAN also showed a significantly higher IgA SI (concentrations of IgA against HP antigens in supernatants from HP-stimulated lymphocytes/IgA against HP antigens in supernatants from unstimulated tonsillar lymphocytes) than did controls (P=0.0004). We found positive correlations between concentrations of IgA and IgG antibodies, between IgA and IgM antibodies, and between IgG and IgM antibodies against HP antigens after HP stimulation.

Conclusions. Our results suggest that HP antigens stimulate tonsillar T and B lymphocytes in patients with IgAN and that these patients have polyclonal activation of lymphocytes against HP antigens, with isotype switching of antibody production from IgM to IgA.

Keywords: B cell; Haemophilus parainfluenzae; IgA nephropathy; T cell; tonsil

Correspondence and offprint requests to: Satoru Suzuki MD, Department of Clinical and Laboratory Medicine, Fukui Medical University, Matsuoka, Fukui, 910–1194 Japan.


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