Tissue deposits of IgA-binding streptococcal M proteins in IgA nephropathy and Henoch-Schonlein purpura

Am J Pathol. 2010 Feb;176(2):608-18. doi: 10.2353/ajpath.2010.090428. Epub 2010 Jan 7.

Abstract

IgA nephropathy (IgAN) and Henoch-Schönlein purpura (HSP) are diseases characterized by IgA deposits in the kidney and/or skin. Both may arise after upper respiratory tract infections, but the pathogenic mechanisms governing these diseases remain unclear. Patients with IgAN (n = 16) and HSP (n = 17) were included in this study aimed at examining whether IgA-binding M proteins of group A streptococci could be involved. As M proteins vary in sequence, the study focused on the IgA-binding-region (IgA-BR) of three different M proteins: M4, M22, and M60. Renal tissue from IgAN and HSP patients and skin from HSP patients were examined for deposits of streptococcal IgA-BR by immunohistochemistry and electron microscopy using specific antibodies, and a skin sample from a HSP patient was examined by mass spectrometry. IgA-BR deposits were detected in 10/16 IgAN kidneys and 7/13 HSP kidneys. Electron microscopy demonstrated deposits of IgA-BRs in the mesangial matrix and glomerular basement membrane, which colocalized with IgA. Skin samples exhibited IgA-BR deposits in 4/5 biopsies, a result confirmed by mass spectrometry in one patient. IgA-BR deposits were not detected in normal kidney and skin samples. Taken together, these results demonstrate IgA-BR from streptococcal M proteins in patient tissues. IgA-BR, would on gaining access to the circulation, encounter circulatory IgA and form a complex with IgA-Fc that could deposit in tissues and contribute to the pathogenesis of IgAN and HSP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Amino Acid Sequence
  • Antigens, Bacterial / chemistry
  • Antigens, Bacterial / immunology
  • Antigens, Bacterial / metabolism*
  • Bacterial Outer Membrane Proteins / chemistry
  • Bacterial Outer Membrane Proteins / immunology
  • Bacterial Outer Membrane Proteins / metabolism*
  • Biopsy
  • Carrier Proteins / chemistry
  • Carrier Proteins / immunology
  • Carrier Proteins / metabolism*
  • Child
  • Child, Preschool
  • Female
  • Glomerulonephritis, IGA / metabolism*
  • Glomerulonephritis, IGA / pathology
  • Humans
  • IgA Vasculitis / metabolism*
  • IgA Vasculitis / pathology
  • Immunoglobulin A / metabolism*
  • Immunohistochemistry
  • Kidney / metabolism
  • Kidney / pathology
  • Male
  • Microscopy, Electron
  • Molecular Sequence Data
  • Precipitins / metabolism*
  • Precipitins / ultrastructure
  • Protein Binding
  • Skin / metabolism
  • Skin / pathology
  • Skin / ultrastructure
  • Young Adult

Substances

  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins
  • Carrier Proteins
  • Immunoglobulin A
  • Precipitins
  • streptococcal M protein