THE ROLE OF ANTI-GLOMERULAR BASEMENT MEMBRANE ANTIBODY IN THE PATHOGENESIS OF HUMAN GLOMERULONEPHRITIS

doi:10.1084/jem.126.6.989

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THE ROLE OF ANTI-GLOMERULAR BASEMENT MEMBRANE ANTIBODY IN THE PATHOGENESIS OF HUMAN GLOMERULONEPHRITIS

R. A. Lerner M.D.¹, R. J. Glassock M.D.¹, and Frank J. Dixon M.D.¹

¹ From the Department of Experimental Pathology, Scripps Clinic and Research Foundation, La Jolla, California 92037, and the Cardiorenal Section, Peter Bent Brigham Hospital, Harvard Medical School, Boston, Massachusetts 02115

These observations established the presence of anti-GBM antibodiesin the sera and/or kidneys of six humans with glomerulonephritis.Further, it seems clear that these antibodies do combine withthe host's glomeruli in vivo and with GBM antigen of severalspecies in vitro.

Transfer of acute glomerulonephritis to normalrecipient monkeys was possible with serum or renal eluate IGGfrom the three patients with anti-GBM antibodies in whom sufficientmaterial was available. Based on this transfer of nephritisand on the presence of these antibodies at the site of injuryin the nephritic kidneys of both the patients and the recipientmonkeys, it seems likely that they are at least a contributing,if not primary, cause of the glomerular injury.

The frequencyof anti-GBM antibodies in human nephritis is not certain, buton the basis of preliminary observations it would appear thatthey are present in all cases of Goodpasture's nephritis andsomewhat less than half of the cases of subacute and chronicglomerulonephritis of adults.

The nature and source of immunogenstimulating the production of anti-GBM antibodies is not known,but the presence of potentially nephritogenic GBM antigens innormal urine raises the question of possible autoimmunization.

Froma practical point of view, it appears that patients forminganti-GBM antibodies may not be good candidates for renal transplantationsince they are likely to produce in the transplants the nephriticchanges already suffered by their own kidneys.

Submitted on July 5, 1967

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