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Abstract：
OBJECTIVE: Tubulointerstitial nephritis (TIN) has various etiologies, including IgG4-related disease (IgG4-RD), autoimmune diseases, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), and others. IgG4-positive plasma cell infiltration can occasionally be found in TIN unrelated to IgG4-RD. Therefore, there may be problems with usage of IgG4 immunostaining to differentiate between TIN with and TIN without IgG4-RD. This study aimed to compare the proportion of plasma cells that are positive for each IgG subclass and to clarify the predominant IgG subclass trends and clinical characteristics associated with IgG4-RD and non-IgG4-related interstitial nephritis.
METHODS: The study enrolled 44 cases of TIN: 6 of IgG4-RD, 8 of autoimmune disease, 9 of AAV, and 21 of unknown disease group. In addition to clinical characteristics, IgG subclass composition of interstitial plasma cells was evaluated among 4 groups by immunohistochemistry.
RESULTS: IgG1 was the predominant IgG subclass in TIN unrelated to IgG4-RD. In the IgG4-RD group, the IgG subclass rate was high in both IgG1 and IgG4. The rate of average IgG4-positive cells was significantly lower in the autoimmune disease group and unknown disease group compared with the IgG4-RD group.
CONCLUSIONS: The present study revealed IgG1-dominant immune profiles of TIN unrelated to IgG4-RD. Further investigation is required to elucidate the clinicopathological differences between IgG1-dominant and IgG4-dominant groups in IgG4-RD.
METHODS: The study enrolled 44 cases of TIN: 6 of IgG4-RD, 8 of autoimmune disease, 9 of AAV, and 21 of unknown disease group. In addition to clinical characteristics, IgG subclass composition of interstitial plasma cells was evaluated among 4 groups by immunohistochemistry.
RESULTS: IgG1 was the predominant IgG subclass in TIN unrelated to IgG4-RD. In the IgG4-RD group, the IgG subclass rate was high in both IgG1 and IgG4. The rate of average IgG4-positive cells was significantly lower in the autoimmune disease group and unknown disease group compared with the IgG4-RD group.
CONCLUSIONS: The present study revealed IgG1-dominant immune profiles of TIN unrelated to IgG4-RD. Further investigation is required to elucidate the clinicopathological differences between IgG1-dominant and IgG4-dominant groups in IgG4-RD.
摘要：
目的：肾小管间质性肾炎（TIN）有多种病因，包括IgG4相关疾病（IgG4-RD），自身免疫性疾病，抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV），和其他人。在与IgG4-RD无关的TIN中偶尔可以发现IgG4阳性浆细胞浸润。因此,使用IgG4免疫染色来区分含TIN和不含IgG4-RD的TIN可能存在问题。这项研究旨在比较每个IgG亚类阳性的浆细胞比例，并阐明与IgG4-RD和非IgG4相关的间质性肾炎相关的主要IgG亚类趋势和临床特征。
方法：本研究纳入了44例IgG4-RD的TIN:6，8自身免疫性疾病，9的AAV，和21个未知疾病组。除了临床特点，通过免疫组织化学评估了4组之间间质浆细胞的IgG亚类组成。
结果：IgG1是与IgG4-RD无关的TIN中主要的IgG亚类。在IgG4-RD组中，IgG1和IgG4的IgG亚类率都很高。自身免疫性疾病组和未知疾病组的平均IgG4阳性细胞率明显低于IgG4-RD组。
结论：本研究揭示了与IgG4-RD无关的TIN的IgG1优势免疫谱。需要进一步研究以阐明IgG4-RD中IgG1优势和IgG4优势组之间的临床病理差异。
方法：本研究纳入了44例IgG4-RD的TIN:6，8自身免疫性疾病，9的AAV，和21个未知疾病组。除了临床特点，通过免疫组织化学评估了4组之间间质浆细胞的IgG亚类组成。
结果：IgG1是与IgG4-RD无关的TIN中主要的IgG亚类。在IgG4-RD组中，IgG1和IgG4的IgG亚类率都很高。自身免疫性疾病组和未知疾病组的平均IgG4阳性细胞率明显低于IgG4-RD组。
结论：本研究揭示了与IgG4-RD无关的TIN的IgG1优势免疫谱。需要进一步研究以阐明IgG4-RD中IgG1优势和IgG4优势组之间的临床病理差异。
