各種糸球体腎炎におけるMembrane Attack Complexの沈着の観察

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  • Membrane attack complex deposition in various glomerular diseases.

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The late components of complement, C5b through C9 constitute membrane attack complex (MAC). Using a monoclonal antibody to a neoantigen expressed on MAC, we localized MAC in the tissue sections from normal kidneys and biopsy specimens from patients with a variety of kidney diseases. In the normal kidneys, MAC was present in a granular pattern along the segments of tubular basement membrane (TBM) and the wall of blood vessels, and weakly in the glomerular mesangium. MAC deposition was observed in the mesangial area and along the glomerular capillary walls of patients with IgA nephropathy, Henoch-Schonlein purpura nephritis, lupus nephritis, membranous nephropathy and membranoproliferative glomerulonephritis. The MAC was frequently co-deposited with C3 and IgG or IgA, suggesting MAC was formed in situ and associated with immune deposits. In patients with oligomeganephronia and hemolytic uremic syndrome, mesangial MAC deposition was generally dissociated with C3 or immunoglobulins, implying that MAC was entrapped from the circulation. In IgA nephropathy, there was no correlation between glomerular MAC deposition and clinical findings of the patients, i. e. renal function, proteinuria or renal histology.

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