title: Streptococcal M protein enhances TGF-beta production and increases surface IgA-positive B cells in vitro in IgA nephropathy.
abstract: BACKGROUND
  High serum levels and enhanced in vitro production of IgA are observed in more than half of patients with IgA nephropathy (IgAN); and transforming forming growth factor-beta (TGF-beta) is certain IgA class switching factor. On the other hand, macroscopic haematuria appears frequently with upper respiratory infection as tonsillitis in IgAN.
  
  
  METHODS
  We compared the lymphocytic response to in-vitro stimulation by group A streptococcal M proteins of apparent virulence factor between IgAN, non-proliferative glomerulonephritis (NPGN), and normal subjects. M proteins were extracted from group A streptococcal strain type 5 and type 12 determined serologically.
  
  
  RESULTS
  M protein-induced proliferation of lymphocytes from IgAN was higher than in NPGN but not in healthy control subjects. Flow cytometric analysis indicated that stimulation by M protein extracts derived from type 5 streptococci (M5) increased surface IgA-positive B cells in IgAN, but did not activate the production of soluble IgA. We also showed that M5 induced significant increases in TGF-beta, in culture supernatants of lymphocytes from patients with IgAN.
  
  
  CONCLUSIONS
  Our results suggest that Streptococcal infection may play an important role in the pathogenesis of IgAN by stimulating IgA production through TGF-beta synthesis.
authors.affiliation: The Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nishikawa
authors.forename: R
authors.initials: R
authors.lastname: Shibata
authors.forename: Y
authors.initials: Y
authors.lastname: Ozono
authors.forename: H
authors.initials: H
authors.lastname: Ichinose
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: T
authors.initials: T
authors.lastname: Harada
authors.forename: S
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial / Q000276:immunology; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins / Q000276:immunology* / Q000494:pharmacology; D002352:Carrier Proteins / Q000276:immunology* / Q000494:pharmacology; D002478:Cells, Cultured; D005921:Glomerulonephritis / Q000097:blood / Q000276:immunology*; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D016130:Immunophenotyping; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000276:immunology*; D008875:Middle Aged; D011947:Receptors, Antigen, B-Cell / Q000097:blood*; D012016:Reference Values; D016212:Transforming Growth Factor beta / Q000097:blood* / Q000235:genetics
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D002352:Carrier Proteins; D007070:Immunoglobulin A; D011947:Receptors, Antigen, B-Cell; D016212:Transforming Growth Factor beta; C014689:streptococcal M protein