Identification of a monocyte phagocytic defect in a subpopulation of patients with nephritis

Experimental studies have demonstrated the cardinal role played by the mononuclear phagocyte system in the removal of antigen-antibody complexes. To assess the functional capacity of phagocytes in patients with renal disease, 33 normal subjects, 10 patients with mesangial proliferative glomerulonephritis, 8 patients with membranous nephropathy, and 8 patients with moderately severe chronic renal failure were studied by an in vitro assay, measuring the ability of isolated monocytes to ingest sheep erythrocytes coated with IgG antibody and to phagocytize latex beads. Monocytes from four patients with mesangial proliferative glomerulonephritis and one patient with membranous nephropathy exhibited a subnormal capacity to ingest the antibody-coated erythrocytes. Additionally, monocytes from two of the four patients with mesangial proliferative glomerulonephritis and a defect in ingesting sensitized erythrocytes had a subnormal capacity to phagocytize latex beads. The results are interpreted in the context of a hypothesis which suggests that patients with immune nephritis show various forms of immune deficit.