Response of circulating immune complexes to food challenge in relapsing IgA nephropathy |
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Authors: | John Feehally T James Beattie Paul E C Brenchley Beatrice M Coupes Netar P Mallick Robert J Postlethwaite |
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Institution: | (1) Department of Renal Medicine, Manchester Royal Infirmary, M27 1HA Manchester, UK;(2) Department of Renal Medicine, Royal Manchester Children's Hospital, M27 1HA Manchester, UK;(3) Department of Medicine, Leicester Royal Infirmary, Clinical Sciences Building, P. O. Box 65, LE2 7LX Leicester, UK |
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Abstract: | The response of circulating immune complexes (CIC) to food challenge was assessed in 15 subjects with IgA nephropathy (IgAN) and recurrent macroscopic haematuria. CIC were measured by solid-phase C1q binding assay (SP-C1q), immunoglobulin class-specific polyethylene glycol (PEG) precipitation assays (PEG-G, PEG-A, PEG-M) and by an antigen (ovalbumin)-specific radioimmunoassay after acid dissociation (OA-IC). CIC were measured when the subjects were fasting and hourly for 6 h after a test meal containing eggs. All 15 subjects were tested while clinically quiescent (remission) and 6 were tested again during episodes of macroscopic haematuria (relapse). The PEG-A CIC response to food challenge was significantly exaggerated in IgAN remission compared with controls at 3–6 h after food. There were also non-significant increases in PEG-G, though not in PEG-M. Paired data showed further exaggeration of PEG-G, PEG-A and PEG-M responses to food during IgAN relapse, but significance was not attained if the findings in 1 subject were separated. In this individual a florid clinical relapse with transient decline in renal function was associated with very high levels of PEG-IC, and only in this patient in relapse was OA-IC detectable, confirming that some PEG-precipitated material represented antigen-antibody complexes containing food antigen. |
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Keywords: | IgA nephropathy Haematuria Circulating immune complexes Food antigens Ovalbumin |
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