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IgA, glomerulonephritis and liver disease

Australian and New Zealand Journal of Medicine

|January 1, 1981

Summary

Soluble immune complexes containing IgA are linked to IgA nephropathy. Liver disease and impaired reticuloendothelial function may contribute to immune complex formation and deposition in kidneys.

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Area of Science:

Nephrology
Immunology
Hepatology

Background:

Soluble immune complexes (IC) are implicated in IgA nephropathy pathogenesis.
These intermediate-sized IC contain IgA, IgG, and IgM, potentially forming due to exogenous antigens or immune system defects.
The liver's role in clearing antigens, polymeric IgA, and IC is crucial; liver disease is associated with hyperimmunization and circulating IC.

Purpose of the Study:

To investigate the role of soluble immune complexes (IC) in IgA nephropathy.
To explore the association between liver disease, immune complex formation, and IgA deposition.
To evaluate the potential link between reticuloendothelial function and IgA nephropathy.

Main Methods:

Analysis of soluble immune complexes (IC) in IgA nephropathy patients.
Autopsy examination of IgA deposits in patients with alcoholic cirrhosis versus controls.
Detection of serum antibodies to E. coli and bovine serum albumin (BSA) in cirrhosis patients.
Induction of cirrhosis and portacaval shunting in rats to study IC and IgA deposition.

Main Results:

Intermediate-sized IC (9-17S) containing IgA, IgG, and IgM were identified.
Significantly higher mesangial, skin, and choroid plexus IgA deposits were found in alcoholic cirrhosis patients compared to controls.
Elevated serum antibodies to E. coli and BSA were observed in cirrhosis patients.
Circulating IC and IgA/C3 mesangial deposits were present in rats with induced cirrhosis and portacaval shunting.

Conclusions:

IgA nephropathy may represent a spectrum from isolated glomerulonephritis to systemic IC disease (Henoch-Schonlein Purpura - HSP).
Primary and secondary forms of IgA nephropathy exist, with liver dysfunction potentially contributing to secondary forms.
Further research on reticuloendothelial function and clearance of IgA polymers/IC is needed for IgA nephropathy and HSP patients.

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