Abstract
Properties which determine whether circulating immune complexes are nephritogenic in man could be influenced by immunological factors affecting antigen antibody ratios, size of complexes, and other characteristics of antibody production. There are conflicting reports on effects of antibody affinity on the development of glomerulonephritis in experimental situations and in human SLE. Our study examines whether the response to immunization with tetanus toxoid differs in patients with glomerulonephritis when compared with normal controls, and whether these differences could reflect the histological type of disease. In patients with glomerulonephritis the hemagglutinating antibody response to tetanus toxoid was reduced compared to normal controls. Mean antibody affinity before injection was higher in patients than in controls, and it rose after immunization in both groups. Six of eight patients with diffuse proliferative glomerulonephritis showed a fall in antibody affinity following injection, in contrast to 10 of 13 controls and 15 of 21 patients with other histological types of disease whose affinity increased. This rise was particularly marked in 3 of 4 patients with mesangiocapillary glomerulonephritis. These data suggest differences in antibody responses of patients with glomerulonephritis and could explain seemingly inconsistent results of previous studies where due regard has not been paid to histological categories. Pathogenesis may vary in different histological forms of the disease in man as in experimental models of the disease.
Published Version
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