Abstract
IgA nephropathy (IgAN) has been considered to have a relationship with infection in the tonsil, because IgAN patients often manifest macro hematuria just after tonsillitis. In terms of oral-area infection, the red complex of periodontal bacteria (Porphyromonas gingivalis (P. gingivalis), Treponema denticol (T. denticola) and Tannerella forsythia (T. forsythia)) is important, but the relationship between these bacteria and IgAN remains unknown. In this study, the prevalence of the red complex of periodontal bacteria in tonsil was compared between IgAN and tonsillitis patients. The pathogenicity of IgAN induced by P. gingivalis was confirmed by the mice model treated with this bacterium. The prevalence of P. gingivalis and T. forsythia in IgAN patients was significantly higher than that in tonsillitis patients (p < 0.001 and p < 0.05, respectively). A total of 92% of tonsillitis patients were free from red complex bacteria, while only 48% of IgAN patients had any of these bacteria. Nasal administration of P. gingivalis in mice caused mesangial proliferation (p < 0.05 at days 28a nd 42; p < 0.01 at days 14 and 56) and IgA deposition (p < 0.001 at day 42 and 56 after administration). Scanning-electron-microscopic observation revealed that a high-density Electron-Dense Deposit was widely distributed in the mesangial region in the mice kidneys treated with P. gingivalis. These findings suggest that P. gingivalis is involved in the pathogenesis of IgAN.
Highlights
IgA nephropathy (IgAN) is one of most common primary glomerulitis nephropathies in Japan and in the world [1,2]
A total of 48% of IgAN patients had more than one red-complex periodontal bacteria, while 92% of tonsillitis patients were free from those red-complex periodontal bacteria (Figure 2)
We revealed that, among the bacteria in the red complex of periodontal bacteria, P. gingivalis and T. forsythia had a prevalence in the tonsils of IgAN patients that was significantly higher than in those with habitual tonsillitis
Summary
IgA nephropathy (IgAN) is one of most common primary glomerulitis nephropathies in Japan and in the world [1,2]. When IgAN patients suffer from tonsillitis, the hematuria sometimes worsens faster than usual, and the removal of tonsils from the IgAN patients ameliorated proteinuria and hematuria [11,12,13]. These features of IgAN indicated that some part of pathogenesis of IgAN has a relationship with infection in oral areas, including the tonsils. Periodontal bacteria are reported to have a strong relationship with systemic diseases [19,20]. Culture methods basically did not work for anaerobic bacteria; it was difficult to reveal the relationship between periodontal bacteria and many diseases, including IgAN
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