The Glomerular IgG Subclasses Analysis And Its Significance In HBV-MN

Objective: The hepatitis B virus associated membranous nephropathy(HBV-MN) is one of the common pathological types of secondarymembranous nephropathy. Renal biopsy shows atypical membranousnephropathy which is mainly caused by immune complexes. Compared withidiopathic membranous nephropathy(IMN), immunofluorescence shows IgG,C3granular deposition, which is accompanied by IgA, IgM, C1q deposition.Immune complex deposits on the capillary wall and glomerular mesangialarea. IgG is an immunoglobulin, and according to the differences among theantigenicity of molecular main chains and the number and location ofdisulfide bond,it can be divided into four types. They have the respectivebiological activity and are involved in the immune response through differentpathways. IgG1and IgG3play a role in the kidney by Th1cells secretecytokines (IL-2, IFN-γ, TNF-β, etc.). IgG4is involved in the immuneresponse mainly by the Th2system activated B cells. Studies have shown thatIgG4is the main ingredient of IgG in IMN. The reports about the depositionof IgG subclasses in membranous lupus nephritis（MLN） are not the same.But the renal tissue IgG subclass expression is rarely reported in HBV-MN. inthis study,we analyzes the characteristics of the deposition of IgG subtypes inthe HBV-MN glomerular deposition.In order to understand the pathogenesisof HBV-MN, and provide the basis for the identification of HBV-MN, IMNand MLN.Methods:1. Research object:(1) Select62cases of patients withHBV-MN who hospitalized in the Second Affiliated Hospital of HebeiMedical University from march of2011to june of2012,and has no diabetes,etc,and is diagnosed by renal biopsy as HBV-MN, and whose blood ofhepatitis B markers positive, to take kidney tissues frozen section line of immunohistochemi.(2)Select35cases of patients with MLN, Select40casesof patients with IMN, and take kidney tissues frozen section line ofimmunohistochemi.2Reagents: First antibody: mouse anti-human IgG1,IgG2, IgG3, IgG4monoclonal antibody; secondary antibodies: rabbitanti-mouse antibody.3. Method: Using the method of immunohistochemicalstaine kidney frozen section, observe the area of sediment and intensity.Results： In HBV-MN group, the deposition intensity of IgG1issignificant different from IgG4,the deposition intensity of IgG1and IgG4aresignificant different from IgG2and IgG3(P <0.05), there is no depositionsignificant difference between IgG2and IgG3(P>0.05). In IMN group, thedeposition intensity of IgG4is significant different from IgG1,the depositionintensity of IgG1and IgG4are significantly different from IgG2and IgG3(P <0.05), there is no deposition significant difference between IgG2andIgG3(P>0.05). In MLN group, the deposition intensity of IgG1.IgG2IgG3issignificantly different from IgG4.there is no deposition significant differencebetween IgG1, IgG2and IgG3(P>0.05).The intensity order of IgG1, IgG2,IgG3deposition in the three membranous nephropathy is MLN> HBV-MN>IMN, the difference is statistically significant (P <0.05).The intensity orderof IgG4deposition in the three membranous nephropathy is IMN> HBV-MN>MLN, the difference is statistically significant (P <0.05).Conclusion：1HBV-MN renal tissue is mainly deposited IgG1. MLN renal tissue ismainly deposited IgG1.IgG2.IgG3. IMN renal tissue is mainly deposited IgG4.2In the three membranous nephropathy, the deposition of IgG subtypesis different. So it can be used as a secondary condition of differential diagnos-is.