Correlation of autoimmune response and immune system components in the progression of IgA nephropathy: A comparative study

Abstract

Background: Immunoglobin-IgA nephropathy (IgAN) stands as the most prevalent primary glomerulonephritis globally. Recently, several studies have mentioned the essential role of the autoimmune response as a mechanism causing Berger's disease, but it is not clear.

Aim: The aims of the study was to assess the correlation between autoimmune competences and explain the roles of certain immune contents in the progression of disease.

Material and method: One hundred and fifty patients participated in the study, including 75 patients with Berger's disease and 75 healthy controls. The chemiluminescence immunoassay technique was employing to assess the level of autoantibodies, while nephelometry was utilizing to quantify the concentration of immunoglobin-related disease and complement proteins (C1q and C4). Simpler, blood smears were accustomed to diagnosing fragments of RBCs (schistocytes), and simple flow cytometry was used to enumerate red blood cells (RBCs) and platelets.

Results: The current study revealed a significantly increased in the schistocytes and lower counts of RBCs in the patients compared to the control. Also, the results showed that the level of ANA, ANCA and dsDNA was highly significant (p < 0.001) in the patients (67.1 ± 2.5 ng/ml, 55.9 ± 12.0 ng/ml, 65.0 ± 2.0 ng/ml respectively) than the control (5.5 ± 0.30 ng/ml, 15.4 ± 1.0 ng/ml, 12.5 ± 0.22 ng/ml, respectively). Furthermore, IgM level was significantly no different (p = 0.755) in a patient (2.8 ± 0.19 ng/ml) compared to the control (2.5 ± 0.26 ng/ml). While the level of IgA and IgG was highly significant (p < 0.001) in the patient (10.3 ± 0.99 ng/ml and 11.6 ± 12 ng/ml respectively) compared to the control (4.2 ± 0.69 ng/ml and 2.8 ± 0.99 ng/ml respectively). Additionally, levels of C4 and C1q were a significantly increase in serum patients than the control group. However, there is a direct correlation between autoimmune antibodies and complement.

Conclusion: There was a strong correlation between immune system components and blood factors, which was identified as a contributing factor in the development of Berger's disease.

Keywords: ANA; ANCA; Autoantibodies; Autoimmune response; Berger’s disease; Disease progression; Hematuria; Ig-RD; IgA nephropathy; Immune system components; Schistocytes; dsDNA.