B and T cell abnormalities in patients with primary IgA nephropathy

The in vitro function of B and T cells was studied in 16 patients with primary IgA nephropahy (PIgA-N). The distribution of OKT3⁺ cells (total peripheral T cells) and of regulatory T cell subsets (helper OKT4⁺ and cytotoxic/suppressor OKT8⁺ cells) was evaluated and a testing for 47 HLA-A, B, C, DR, and DQ antigens was carried out in the 16. B lymphocyte IgA production, after stimulation by pokeweed mitogen in the presence of T cells from normal donors treated with mitomycin C, was significantly greater in patients than in controls. T lymphocytes from patients with PIgA-N were more efficient than T cells from controls in providing IgA specific helper activity for normal B cells. The analysis of the individual data showed that the overactivity of B cells and the T cell operational dysfunction was present in about 50% of the patients and did not correlate. No numerical imbalance between T lymphocyte subsets nor any association between lymphocyte behavior, HLA antigen distribution, and a number of clinical, laboratory, and immunohistological findings was observed. Our data, therefore, suggest that PIgA-N is an immunologically heterogeneous disease and that an IgA-specific B cell overcapacity and/or overall IgA-specific T cell helper activity may be present in some patients.