Periodontal disease bacteria specific to tonsil in IgA nephropathy patients predicts the remission by the treatment.
BACKGROUND
Immunoglobulin (Ig)A nephropathy (IgAN) is the most common form of primary glomerulonephritis in the world. Some bacteria were reported to be the candidate of the antigen or the pathogenesis of IgAN, but systematic analysis of bacterial flora in tonsil with IgAN has not been reported. Moreover, these bacteria specific to IgAN might be candidate for the indicator which can predict the remission of IgAN treated by the combination of tonsillectomy and steroid pulse.


RESULTS
We made a comprehensive analysis of tonsil flora in 68 IgAN patients and 28 control patients using Denaturing gradient gel electrophoresis methods. We also analyzed the relationship between several bacteria specific to the IgAN and the prognosis of the IgAN. Treponema sp. were identified in 24% IgAN patients, while in 7% control patients (P = 0.062). Haemophilus segnis were detected in 53% IgAN patients, while in 25% control patients (P = 0.012). Campylobacter rectus were identified in 49% IgAN patients, while in 14% control patients (P = 0.002). Multiple Cox proportional-hazards model revealed that Treponema sp. or Campylobactor rectus are significant for the remission of proteinuria (Hazard ratio 2.35, p = 0.019). There was significant difference in remission rates between IgAN patients with Treponema sp. and those without the bacterium (p = 0.046), and in remission rates between IgAN patients with Campylobacter rectus and those without the bacterium (p = 0.037) by Kaplan-Meier analysis. Those bacteria are well known to be related with the periodontal disease. Periodontal bacteria has known to cause immune reaction and many diseases, and also might cause IgA nephropathy.


CONCLUSIONS
This insight into IgAN might be useful for diagnosis of the IgAN patients and the decision of treatment of IgAN.
Department of Geriatric Medicine and Nephrology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan ; Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-Cho, Nishinomiya, Japan.
Yasuyuki
Y
Nagasawa
Department of Geriatric Medicine and Nephrology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Kenichiro
K
Iio
Laboratory for Epithelial Immunobiology, RIKEN Research Center for Allergy and Immunology, Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa, Japan ; Graduate School of Nanobioscience, Yokohama City University, Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa, Japan ; Institute for Advanced Biosciences, Keio University, Mizukami, Kakuganji, Tsuruoka, Yamagata, Japan.
Shinji
S
Fukuda
Laboratory for Epithelial Immunobiology, RIKEN Research Center for Allergy and Immunology, Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa, Japan ; Department of Life Science and Medical Bioscience, Waseda University, Wakamatsu-cho, Shinjuku-ku, Tokyo, Japan.
Yasuhiro
Y
Date
Department of Geriatric Medicine and Nephrology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Hirotsugu
H
Iwatani
Department of Geriatric Medicine and Nephrology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Ryohei
R
Yamamoto
Department of Otolaryngology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Arata
A
Horii
Department of Otolaryngology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Hidenori
H
Inohara
Department of Geriatric Medicine and Nephrology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Enyu
E
Imai
Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-Cho, Nishinomiya, Japan.
Takeshi
T
Nakanishi
Laboratory for Epithelial Immunobiology, RIKEN Research Center for Allergy and Immunology, Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa, Japan ; Graduate School of Nanobioscience, Yokohama City University, Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa, Japan.
Hiroshi
H
Ohno
Department of Geriatric Medicine and Nephrology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Hiromi
H
Rakugi
Department of Geriatric Medicine and Nephrology, Osaka University, Graduate School of Medicine, Yamada-oka, Suita, Osaka, Japan.
Yoshitaka
Y
Isaka
D000328:Adult; D064208:Aggregatibacter segnis / Q000472:pathogenicity; D044883:Campylobacter rectus / Q000472:pathogenicity; D005260:Female; D005922:Glomerulonephritis, IGA / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D014066:Palatine Tonsil / Q000382:microbiology*; D010510:Periodontal Diseases / Q000382:microbiology* / Q000503:physiopathology*; D016016:Proportional Hazards Models; D013256:Steroids / Q000627:therapeutic use; D014208:Treponema / Q000472:pathogenicity
D013256:Steroids