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Nephrol Dial Transplant (1992) 7: 293-299
© 1992 European Renal Association-European Dialysis and Transplant Association

research-article

Presence of circulating antibodies against brush border antigens (FxlA) in a patient with membranous nephropathy and bilateral pyeloureteral stenosis. Comparison with idiopathic membranous nephropathy

J. González-Cabrero1, R. de Nicolas1, A. Ortiz1, F. Mampaso2, L. Hernando1 and J. Egido1,

1Fundación Jiménez Diaz, Universidad Autónoma CSIC; 2Hospital Ramón y Cajal Madrid, Spain

Correspondence and offprint requests to: Dr J. Egido, Servicio de Nefrologia, Fundación Jiménez Diaz, Avda Reyes Catòlicos 2, 28040 Madrid, Spain

In a patient with membranous nephropathy and bilateral pyeloureteral stenosis with hydronephrosis, we examined the possibility that an increase in the intratubular pressure could facilitate the passage of the FxlA antigens to the circulation. Elevated serum anti-FxlA antibodies were detected in this particular patient by ELISA on three occasions during the disease follow-up, even though he was in clinical remission. These antibodies reacted in vitro with the tubular brush border of a normal human kidney. The anti-FxlA antibodies isolated from the patient’s sera by affinity chromatography competed with the rabbit anti-FxlA antisera binding to plates coated with human FxlA antigen. In immunoblotting studies the isolated specific IgG antibodies from that patient reacted with a 180 kDa antigen of the human FxlA and with less intensity with 75 kDa and 50–55 kDa polypeptides. In none of 12 patients with idiopathic membranous nephropathy could the circulating anti-FxlA antibodies be demonstrated. On the whole, this particular case suggests that on some occasions increased intratubular pressure could cause the release of FxlA antigens, facilitating an autologous immunocomplex nephritis. These antigens, by contrast, do not seem to play any role in most cases of membranous nephropathy in man.

Keywords: anti-FxlA antibodies; bilateral pyeloureteral stenosis; membranous nephropathy; renal tubular antigens


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