study of pathogenesis of IgA neuropathy

IgA肾病（IgAN）的特点是存在IqA沉积，主要在肾小球系膜。关于其发病机制，一些研究者认为肾小球中IgA N的沉积是针对病毒、细菌或饮食抗原的抗体（Ab），因此Ab可能是作为宿主对各种环境抗原的特异性免疫反应的一部分而产生的。我们以前观察到，副流感嗜血杆菌（HP）从IgAN患者的咽部比从其他肾小球疾病患者的咽部更常见。我们还发现，在IgAN患者中，HP抗原外膜的肾小球沉积（OMHP）和抗OMHP的IgA-Ab血清浓度升高。此外，我们已经证明，IgAN患者通过多克隆激活，针对OMHP的IgA- ab的产生特异性增加，从一种同型转换到另一种同型，例如从IgM到IgA，并且IgAN患者抗OMHP的IgA- ab与肾脏病变之间存在更显著的关系。并且OMHP刺激扁桃体b淋巴细胞产生针对IgAN患者OMHP和扁桃体t淋巴细胞的特异性lqA1-Ab。我们的目的是研究OMHP刺激诱发IgAN患者扁桃体淋巴细胞（TL）产生IgA和几种细胞因子的情况。我们使用IgAN患者和慢性扁桃体炎但无肾脏疾病患者的腭扁桃体TL作为对照。所有患者扁桃体切除术前均检测到HP。我们检测了淋巴细胞与OMHP孵育后培养上清中抗OMHP的IgA-Ab和细胞因子的产生。IgAN患者的TL自发产生的总IgA和TGF-β高于对照组。体外OMHP刺激可促进IgAN患者的TL产生hp特异性IgA，而对照组的TL则无此作用。OMHP刺激也增强了IgAN患者TL对TGF-β和IL-10的产生。IgAN患者的自发IFN-γ生成量和自发总IgA生成量高于对照组。IgAN患者中OMHP刺激诱导的IFN-γ也高于对照组。在IgAN患者和对照组中，IFN-γ的产生与总IgA值呈正相关。少

IgA nephropathy (IgAN) is characterized by the presence of IqA deposits, predominantly in the qlomerular mesangium. Concerning its pathogenesis, several investigators have suggested that the glomerular IgA deposits in IgA N are antibodies (Ab) to viral, bacterial or dietary antigens Thus the Ab are probably produced as part of the specific host immune response to various environmental antigens. We have observed previously that Haemophilus parainfluenzae (HP) is more commonlyisolated from the pharynx of patients with IgAN than from those with other glomerular diseases. We have also identified the glomerular deposition of outer membranes of HP antigens (OMHP) and an increased serum concentration of IgA-Ab against OMHP in patients with IgAN. Furthermore, We have shown that patients with IgAN have a specific increase in the production of IgA-Ab against OMHP via polyclonal activation against these, with switching of production from one isotype to another, e.g. from IgM to IgA, and that a si … More gnificant relationship between IgA-Ab against OMHP and renal lesions exists in patients with IgAN, and that OMHP stimulate tonsillar B-lymphocvtes to produce specific lqA1-Ab against OMHP and tonsillar T-lvmphocytes in patients with IgAN.Our objective was to investigated the production of IgA and several cytokines by tonsillar lymphocytes (TL) from patients with IgAN induced by stimulation with OMHP. We used TL from the palatine tonsils of patients with IgAN and patients with chronic tonsillitis but without renal diseases as controls. HP was detected in the tonsils of all patients before tonsillectomy. We examined production of IgA-Ab against OMHP and cytokines in the culture supernatants after lymphocyte incubation with OMHP. The spontaneous production of total IgA and TGF-β by TL from patients with IgAN was higher than that by TL from controls. Stimulation with OMHP in vitro enhanced the production of HP-specific IgA by TL from patients with IgAN, but not by TL from controls. OMHP stimulation also enhanced the production of TGF-β and IL-10 by TL from patients with IgAN. Spontaneous IFN-γ production and spontaneous total IgA production by TL were higher in IgAN patients than in controls. IFN-γ induction by OMHP stimulation was also higher in IgAN patients than in controls. IFN-γ production was positively correlated with total IgA values in both IgAN patients and controls. Less