Expression and significance of glomerular galactose-deficient IgA1 in glomerular disease characterized by abnormal deposition of IgA
WANG Fanghao
SHANG Wenya
LI Hongfen
LIU Youxia
XING Yue
WU Zhanfei
LI Wenying
WEI Li
CHEN Jinju
JIA Junya
Abstract：Objective To explore the expression and significance of glomerular galactose-deficient IgA1(Gd-IgA1)in glomerular disease characterized by abnormal deposition of IgA.Methods Thirty-five patients with glomerular disease characterized by abnormal deposition of IgA who were admitted to Tianjin Medical University General Hospital from January 2020 to June 2024 were included as the IgA abnormal deposition group,including 5 cases of IgA-dominant infection-related glomerulonephritis(IgA-IRGN),8 cases of diabetic nephropathy with IgA deposition(IgA-DN),9 cases of anti-neutrophil cytoplasmic antibodies(ANCA)-associated glomerulonephritis with IgA deposition(IgA-ANCA-GN),and 13 cases of minimal change disease with IgA deposition(IgA-MCD).Other 35 sex-and age-matched primary IgA nephropathy(IgAN)patients hospitalized during the same period were selected as the controls(IgAN group).The clinical and pathological features of the patients in the two groups were analyzed,and the intensity and distribution characteristics of Gd-IgA1 staining in glomeruli in renal biopsy were evaluated.Results The main clinical manifestations of the patients in the two groups were proteinuria and(or)hematuria,and elevated levels of blood creatinine.The results of renal pathological examination showed that endocapillary proliferation was more common in the patients in the IgAN group,while fibrinoid necrosis,crescent formation and basement membrane thickening were more common in the patients in the IgA abnormal deposition group.The results of immunohistochemical staining of Gd-IgA1 antibody KM55 showed that KM55 was mainly expressed in the mesangial region in the IgAN group,and the staining intensity ranged from mildly positive(+)to strongly positive(+++),and the staining intensity in the patients of the IgAN group was significantly higher than that in the patients of the IgA abnormal deposition group(P＜0.05).The results of electron microscopy examination showed that the location of electron-dense deposits(EDD)in the glomeruli of the IgAN group was consistent with the IgA immunofluo-rescence and the KM55 staining.The location of glomerular EDD in the IgA abnormal deposition group was consistent with the IgA immunofluorescence staining,but was poorly consistent with the KM55 staining.Conclusion In the glomerular disease characterized by abnormal deposition of IgA,glomerular Gd-IgA1 deposition is significantly less than glomerular IgA deposition,which suggests that Gd-IgA1 may not play an important role in its pathogenesis.
Keywords：Galactose-deficient IgA1(Gd-IgA1)IgA nephropathy(IgAN)Abnormal deposition of IgA
Publication Date：2024-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 846-851 )