Abstract
The response of circulating immune complexes (CIC) to food challenge was assessed in 15 subjects with IgA nephropathy (IgAN) and recurrent macroscopic haematuria. CIC were measured by solid-phase C1q binding assay (SP-C1q), immunoglobulin class-specific polyethylene glycol (PEG) precipitation assays (PEG-G, PEG-A, PEG-M) and by an antigen (ovalbumin)-specific radioimmunoassay after acid dissociation (OA-IC). CIC were measured when the subjects were fasting and hourly for 6 h after a test meal containing eggs. All 15 subjects were tested while clinically quiescent (remission) and 6 were tested again during episodes of macroscopic haematuria (relapse). The PEG-A CIC response to food challenge was significantly exaggerated in IgAN remission compared with controls at 3–6 h after food. There were also non-significant increases in PEG-G, though not in PEG-M. Paired data showed further exaggeration of PEG-G, PEG-A and PEG-M responses to food during IgAN relapse, but significance was not attained if the findings in 1 subject were separated. In this individual a florid clinical relapse with transient decline in renal function was associated with very high levels of PEG-IC, and only in this patient in relapse was OA-IC detectable, confirming that some PEG-precipitated material represented antigen-antibody complexes containing food antigen.
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Woodroffe AJ, Clarkson AJ, Seymour AE, Lomax-Smith JD (1982) Mesangial IgA nephritis. Springer Semin Immunopathol 5:321–332
Couser WG, Salant DJ (1980) In situ immune complex formation and glomerular injury. Kidney Int 17:1–13
Mauer SM, Sutherland RJ, Howard AJ, Fish AJ, Najarian S, Michael AF (1973) The glomerular mesangium. III: Acute mesangial injury: a new model of glomerulonephritis. J Exp Med 137:553–570
Stachura I (1983) Immune complexes in IgA nephropathy (Berger's disease). Pathol Annu 18:295–314
Paganelli R, Levinsky RJ, Brostoff J (1979) Immune complexes containing food proteins in normal and atopic subjects after oral challenge and effect of sodium cromoglycate on antigen absorption. Lancet I:1270–1272
Cairns SA, London RA, Mallick NP (1981) Circulating immune complexes following food: delayed clearance in idiopathic glomerulonephritis. J Clin Lab Immunol 6: 121–126
Feehally J, Beattie TJ, Brenchley PEC, Coupes BM, Mallick NP, Postlethwaite RJ (1986) Sequential study of the IgA system in relapsing IgA nephropathy. Kidney Int 30: 924–931
Paganelli R, Levinsky RJ, Atherton DJ (1981) Detection of specific food antigen within circulating immune complexes: validation of the assay and its application to food antigen-antibody complexes formed in healthy and foodallergic subjects. Clin Exp Immunol 46:44–53
Delire M, Gambiasco CL, Masson PL (1978) Circulating immune complexes in infants fed on cow's milk. Nature 272:632
Brostoff J, Carini C, Wraith DG, Johns P (1979) Production of IgE complexes by allergen challenge in atopic patients and the effect of sodium cromoglycate. Lancet I: 1268–1270
Egido J, Sancho J, Rivera F, Hernando L (1984) The role IgA and IgG immune complexes in IgA nephropathy. Nephron 36:52–59
Coppo R, Basolo B, Martina G, Rollino C, De Marchi M, Giacchino F, Mazzucco G, Messina M, Piccoli G (1982) Circulating immune complexes containing IgA, IgG and IgM in patients with primary IgA nephropathy and with Henoch-Schonlein nephritis. Clin Nephrol 18:230–239
Woodroffe AJ, Gormley AA, McKenzie PE, Wootten AM, Thompson AJ, Seymour AE, Clarkson AJ (1980) Immunological studies in IgA nephropathy. Kidney Int 18: 366–374
Lesavre P, Digeon M, Bach JF (1982) Analysis of circulating IgA and detection of immune complexes in primary IgA nephropathy. Clin Exp Immunol 48:61–69
Sancho J, Egido J, Rivera F, Hernando L (1983) Immune complexes in IgA nephropathy: presence of antibodies against diet antigens and delayed clearance of specific polymeric IgA immune complexes. Clin Exp Immunol 54: 194–202
Russell MW, Mestecky J, Julian BA, Galla JH (1986) IgA-associated renal diseases: antibodies to environmental antigens in sera and deposition of immunoglobulins and antigens in glomeruli. J Clin Immunol 6:74–86
Coppo R, Basolo B, Rollino C, Roccatello D, Martina G, Amore A, Borgiorno G, Piccoli G (1986) Mediterranean diet and primary IgA nephropathy. Clin Nephrol 26: 72–82
Egido J, Blasco R, Sancho J, Lozano L (1983) T cell dysfunctions in IgA nephropathy: specific abnormalities in the regulation of IgA synthesis. Clin Immunol Immunopathol 26:201–212
Andre F, Druguet M, Andre C (1978) Effect of food intake on circulating antigen antibody complexes in patients with alcoholic liver cirrhosis. Digestion 17:554–559
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Feehally, J., Beattie, T.J., Brenchley, P.E.C. et al. Response of circulating immune complexes to food challenge in relapsing IgA nephropathy. Pediatr Nephrol 1, 581–586 (1987). https://doi.org/10.1007/BF00853592
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DOI: https://doi.org/10.1007/BF00853592