Following recent experimental data suggesting an aggravating effect of circulating proinflammatory cytokines on the histological lesions of IgAN, we studied changes in serum proinflammatory cytokines and their soluble receptors and antagonists in patients treated with polyvalent immunoglobulins (15 with severe nephropathy who had indicators of poor prognosis: heavy proteinuria, hypertension, altered renal function and Lee's histological grade III or IV; and 14 with moderate forms of IgAN who had permanent albuminuria > 300 mg/day and < 2000 mg/day, Lee's histological grade II and a glomerular filtration rate > 70 ml/min) in comparison with healthy controls (n = 20) and patients with non-IgA nephritides (n = 50). These were measured by means of specific immunometric assays before and after 9 months of immunoglobulin therapy. Total tumour necrosis factor (TNF) serum and IL-6 levels were elevated in IgAN patients before therapy, relative to controls, and normalized after immunoglobulin therapy.
View Article and Find Full Text PDFThe nephrotic syndrome (NS) carries one of the highest risks of thrombotic complications. Consequently, over the last 15 years, some nephrologists have treated patients risk (i.e.
View Article and Find Full Text PDFRecently, our group has shown that a 3-month course of intravenous immunoglobulin (2 g/kg/monthly) followed by 6 months of intramuscular immunoglobulins (IMIG, 16.5%, 0.35 ml/kg every 15 days) was able to slow or to stop the decline in the glomerular filtration rate, to reduce proteinuria, hematuria, leukocyturia and the histological index of activity on renal biopsy in patients with severe forms of IgA nephropathy (IGAN) and Henoch-Schönlein purpura (HSP).
View Article and Find Full Text PDFObjective: To determine if polyvalent IgG is promising therapy for severe IgG nephropathy.
Design: Open prospective cohort study.
Setting: Referral nephrology unit.
To study the specificity of gut hyperpermeability in primary glomerulonephritis, we investigated intestinal permeability by means of 51Cr-EDTA testing in 20 healthy individuals and in 30 patients with Immunoglobulin A nephropathy (IgA GN), 25 with idiopathic nephrotic syndrome (INS) and 20 with immune complex glomerulonephritis (IC-GN; membranous+membranoproliferative glomerulonephritis). Gut permeability was statistically increased in each patient group versus the controls [controls: 2% (0.4-3.
View Article and Find Full Text PDFSecretory immunoglobulin A (IgA) was determined by means of an enzyme-linked immunosorbent assay (using as capture antibody an MoAb specific for secretory component) in saliva and serum from 46 patients with IgA mesangial nephritis (IgAGN), 36 with an idiopathic nephrotic syndrome (INS), 30 with an idiopathic membranous nephropathy (MGN) and 40 healthy controls. Secretory IgA levels were elevated in both saliva and serum of patients with primary glomerulonephritis (P < 0.05; Mann-Whitney test) regardless of the histological type of the primary glomerulonephritis.
View Article and Find Full Text PDFIgA specific for 7 food and 6 airborne antigens were sought in the serum of 30 adult patients with IgA mesangial nephropathy (IgA GN), 23 with membranous nephropathy (MGN), 20 with idiopathic nephrotic syndrome (INS), 11 with membranoproliferative GN (MPGN) and 22 healthy controls by means of an enzyme-linked immunoassay. The IgA subclass was determined using monoclonal antibodies. Increased levels of IgA specific for gliadin, bovine serum albumin (BSA), ovalbumin, lysozyme and alpha-lactalbumin were found in IgA GN, while increased levels of IgA to BSA, ovalbumin, lysozyme and alpha-lactalbumin were observed in MGN; IgA specific for alpha-lactalbumin were increased in INS, and MPGN patients had reduced levels of IgA to BSA and increased levels of IgA to beta-lactoglobulin and alpha-lactalbumin.
View Article and Find Full Text PDFSalivary components (proteins, albumin, IgA1, IgA2, IgG, IgM, beta 2-microglobulin, neopterin and peroxidase) were investigated in 3 adult types of primary glomerulonephritis (PGN): IgA mesangial glomerulonephritis (IgAGN; n = 14); idiopathic membranous glomerulonephritis (n = 8); idiopathic nephrotic syndrome (INS; n = 14), and a control group (n = 11). Salivary IgA1 levels were significantly increased in all these PGN whereas salivary IgA2 levels were only higher than controls in INS. Albumin and proteins did not differ between PGN and controls, while the IgA1 + IgA2/protein ratio was significantly increased in these 3 PGN.
View Article and Find Full Text PDFSerum IgG subclass levels were investigated in 27 IgA GN and HSP patients and 19 healthy paired controls using a panel of monoclonal antibodies. IgG1 and IgG2 were statistically lower than in the controls in both the non-nephrotic and nephrotic patients, and 80% of the non-nephrotic patients exhibited a partial deficiency for either IgG1, IgG2 or IgG3. Urinary losses of IgG only accounted for decreased levels of IgG4.
View Article and Find Full Text PDFAnn Med Interne (Paris)
February 1990
The association of IgA anti-gliadin antibodies and IgA glomerulonephritis (IgA GN) was first reported in 1987 (Am J Nephrol, 1987, 7, 178-183) and has since been confirmed by other groups. We have developed a second generation ELISA (alkaline phosphatase, biotin-avidin) and used it to test 45 adult IgA GN, 34 idiopathic membranous nephropathy (MN), 31 idiopathic nephrotic syndrome (INS), and 11 idiopathic membranoproliferative glomerulonephritis (MPG) patients. IgA anti-gliadin antibodies were found in 24 IgA GN (53%), 1 MN (3%), 1 INS (3%), and 1 MGP (9%) patients.
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