The role of phosphorylcholine-specific immune responses in the tonsils and peripheral blood on IgA nephropathy

Abstract

Background: Tonsillectomy combined with steroid pulse therapy was reported to be effective for patients with IgA nephropathy. However, the mechanisms of the effect of tonsillectomy on IgA nephropathy are unknown.

Aim: The aim of this study was to investigate the involvement of the phosphorylcholine (PC)-specific immune response in the tonsils and peripheral blood of patients with IgA nephropathy.

Material and methods: Tonsillar lymphocytes were isolated and the number of PC-specific immunoglobulin-producing cells was measured. Additionally, serum PC-specific immunoglobulin levels were quantified and compared with laboratory findings.

Results: The number of PC-specific IgA-producing cells was increased in the tonsils of patients with IgA nephropathy. The value was significantly elevated in the group with a higher risk of initiating dialysis. In contrast, PC-specific IgM levels in the serum were significantly elevated in the group with a lower risk of initiating dialysis.

Conclusions and significance: PC-specific immune responses in the tonsils and peripheral blood may be related to the pathological mechanism and progression of IgA nephropathy.

Chinese abstract

背景：扁桃体切除术联合类固醇脉冲治疗据报道是治疗IgA肾病的有效方法。然而, 扁桃体切除术对IgA肾病的作用机制尚不清楚。

目的：本研究旨在探讨磷酸胆碱（PC）特定性免疫反应在IgA肾病患者的扁桃体和外周血中的作用。

材料与方法：分离扁桃体淋巴细胞, 测定产生PC特定性免疫球蛋白的细胞的数目。此外, 对血清PC特定性免疫球蛋白水平进行量化, 并与实验室结果进行比较。

结果：IgA肾病患者扁桃体中产生PC特定性IgA的细胞数量增加了。这种细胞数量在启动透析的风险较高的组中显著升高。相比之下, 血清中PC特定性IgM水平在启动透析的风险较低的组中显著升高。

结论与意义：扁桃体及外周血PC特定性免疫反应可能与IgA肾病的病理机制及病情发展有关。

Keywords:

• IgA nephropathy
• phosphorylcholine
• pathogenesis
• tonsillectomy

Disclosure of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by JSPS KAKENHI Grant Number 16K20263.