Immunofluorescent Studies of Human Renal Tissues I Immunofluorescent studies of human renal tissues of various diseases

• Published in: The Japanese Journal of Nephrology Vol. 12; no. 2; pp. 285 - 304
• Main Author: Murohashi, Takeshi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Nephrology 31.03.1970
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.12.285

Renal tissue from 89 patients (69 with renal diseases and 20 with other disorders) has been studied by the fluorescent antibody technique for the presence of immnoglobulins, IgA, IgG, IgM, fibrinogen and ale in comparison with the light microscopic findings (according to the Kinoshita's classification's ref.) and the laboratory studies. The immunofluorescent findings were classified into six types: The immunofluorescent finding of acute glomerulonephritis (GN) in the active stage was characterized with diffuse fine granular deposits in glomerular capillary wall. There was no prognostic difference between IgA-and/or IgM -positive and negative patients. In the convalescent stage, the fluorescence for IgG became fainter or disappeared. Only in one case, nodular fluorescence with positive mesangial pattern was observed. Subacute GN revealed both capillary and mesangial pattern of IgG and .A1c in fine granular form as well as deposition of IgA and IgM. The main findings in the patients with subchronic GN (a distinct entity of chonic but nonprogressive form without functional insufficiency) were visulized as discontinuous linear and local pattern of IgG and. .A1c in the glomerular walls. The type III and IV of the subchronic GN (a little advanced form and acute exacerbation) revealed mesangial pattern as well as presence of IgA and IgM, which was found almostt parallel with decreased renal functions. In the most patients with chronic GN, discontinuous capillary pattern as well as irregular mesangial pattern of IgG and .A1c and presence of IgA and IgM were prominent. Granular depostion of fibrinogen was found mainly in the mesangial area. Not a case disclosed such a continuous linear pattern without granularity as seen in the experimental nephrotoxic GN. In the cases of contracted kidney, some eighty per cent of glomeruli were free of fluorescence. Only in a few glomeruli was found local irregular pattern of .A1c alone or as well as IgG and IgM. In the nephrotic syndrome, the immunofluorescent findings were very variable. Beaded pattern of IgG and β1c on the glomerular capillary, referred as specific to the so-called membranous nephropathy, was found in some other types of corticosteroid-resistant nephrotic syndrome. Some cases with the less dense bead-like deposits was sensitive to the corticosteroid therapy. Three cases with lupus nephritis showed differdnt findings. The first case without significant morphological change had linear capillary pattern of IgG and β1c. The second case had discontinuous local capillary pattern. The third case showed diffuse fine granular brilliant fluorescence of both capillary and mesangial pattern of IgG, IgA, IgM, β1c and fibrinogen. A case of Alport's syndrome showed capillary and mesangial of IgG and β1c. Cases with rheumatoid arthritis disclosed presence of IgG and β1c along the capillary wall and in some portion of mesangium. The immunofluorescent findings in various diseases were discussed in connection with the clinical pathological aspects.