Immunogenetics and immunopathology of human membranous glomerulonephritis.

Abstract

In most of our membranous glomerulonephritis (MGN) patients, we have studied the HLA-A, B, DR phenotype, the clearance of anti-D rhesus coated 51Cr-labelled autologous erythrocytes, and T-lymphocyte subpopulations with monoclonal antibodies (OKT3, T4, T8). The frequency of B8 antigen in 28 patients with MGN (five cases associated with lupus excluded) is 57.14 per cent versus 14.42 per cent in controls (Pc = 0.0002). In 26 patients the frequency of DR3 antigen is 65.38 per cent versus 20.27 per cent in controls (Pc = 0.00008). The half-life of sensitised erythrocytes is respectively 35.36 +/- 8.50 minutes in nine controls and 67.05 +/- 69.64 min in 18 patients with MGN. The half-life is significantly prolonged in one-third of the patients at time of exacerbation. The peripheral blood T-lymphocyte subsets study showed a significant decrease of OKT3 and OKT4 positive cell subsets. T4/T8 ratio is high during exacerbation of disease and diminishes in remission. Our data are consistent with a latent subtle genetic immunodeficiency, only expressed during acute phases of the disease.