Membranous nephropathy: an IgG4-mediated disease.
Membranous nephropathy is characterised by the deposition of immunoglobulin, predominantly of the IgG4 subclass, along the epithelial surface of the glomerular-basement membrane. Current models of pathogenesis usually assume in-situ immune-complex formation involving an as yet uncharacterised fixed glomerular antigen. I argue that the properties of IgG4 (inability to fix complement and therefore impaired clearance of IgG4-containing complexes; low affinity and therefore ability for IgG4-containing complexes to dissociate and traverse the glomerular-basement membrane) are compatible with a pathogenic mechanism that involves the deposition of circulating IgG4 immune complexes containing diverse antigens.
Oliveira
D B
DB
Division of Renal Medicine, St George's Hospital Medical School, London, UK.
D000818:Animals; D000936:Antigen-Antibody Complex / Q000378:metabolism; D001485:Basement Membrane / Q000276:immunology / Q000378:metabolism; D015433:Glomerulonephritis, Membranous / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D051381:Rats
D000936:Antigen-Antibody Complex; D007074:Immunoglobulin G