Antiglobulins, cryoglobulins and glomerulonephritis: Second International Milano Meeting of Nephrology 30 September – 1 October 1985

291 Pages·1986·18.184 MB·English

by  Richard J. Glassock (auth.), Claudio Ponticelli, Luigi Minetti, Giuseppo D’Amico (eds.)

ANTIGLOBULINS, CRYOGLOBULINS AND GLOMERULONEPHRITIS
DEVELOPMENTS IN NEPHROLOGY
Cheigh JS, Stenzel KH, Rubin AL: Manual of clinical nephrology of the Rogosin
Kidney Center. 1981. ISBN 90-247-2397-3.
Nolph KD ed.: Peritoneal dialysis. 1981. ISBN 90-247-2477-5.
Gruskin AB, Norman ME eds: Pediatric nephrology. 1981.
ISBN 90-247-2514-3.
Schuck 0 ed: Examination of the kidney function. 1981. ISBN 0-89838-565-2.
Strauss Jed: Hypertension, fluid-electrolytes and tubulopathies in pediatric
nephrology. 1982. ISBN 90-247-2633-6.
Strauss Jed: Neonatal kidney and fluid-electrolytes. 1983.
ISBN 0-89838-575-X.
Strauss Jed: Acute renal disorders and renal emergencies. 1984.
ISBN 0-89838-663-2.
Didio LJA, Motta PM eds: Basic, clinical, and surgical nephrology. 1985.
ISBN 0-89838-698-5.
Friedman EA, Peterson CM eds: Diabetic nephropathy: Strategy for therapy.
1985. ISBN 0-89838-735-3.
Dzurik R, Lichardus B, Guder Weds: Kidney metabolism and function. 1985.
ISBN 0-89838-749-3.
DiDio LJA, Motta PM eds: Basic, clinical, and surgical nephrology. 1985.
ISBN 0-89838-698-5.
Oreopoulos DG ed: Geriatric nephrology. 1986. ISBN 0-89838-781-7.
Pajamin EP ed: Acute Continuous Renal Replacement Therapy. 1986.
ISBN 0-89838-793-0.
Cheigh JS, Stenzel KH, Rubin AL eds: Hypertension in Kidney Disease. 1986.
ISBN 0-89838-797-3.
Deane N, Wiheman RJ, Benis GA eds: Guide to Reprocessing of Hemodialyzers.
1986. ISBN 0-89838-798-1.
Ponticelli C, Minetti L, D'Amico G eds: Antiglobulins, Cryoglobulins and
Glomerulonephritis. 1986. ISBN 0-89838-810-4.
Antiglobulins,
cryoglobulins and
glolDerulonephritis
Second International Milano Meeting of Nephrology
30 September - 1 October 1985
edited by
CLAUDIO PONTI CELLI
Maggiore Hospital, Milan
LUIGI MINETTI
Ca' Grande Hospital, Milan
GIUSEPPO D'AMICO
San Carlo Hospital, Milan
1986 MARTINUS NIJHOFF PUBLISHERS
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
DORDRECHT / BOSTON / LANCASTER
Distributors
for the United States and Canada: Kluwer Academic Publishers, 101 Philip
Drive, Assinippi Park, Norwell, MA 02061, USA
for the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited,
Falcon House, Queen Square, Lancaster LAl lRN, UK
for all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O. Box 322, 3300 AH Dordrecht, The Netherlands
Book information
ISBN-13:978-94-010-8406-2 e-ISBN-13:978-94-009-4289-9
DOl: 10.1007/978-94-009-4289-9
Library of Congress Cataloging in Publication Data
International Milano Meeting of Nephrology (2nd
1985)
Antiglobulins, cryoglobulins, and glomerulonephritis.
(Developments in nephrology)
Includes index.
1. Glumerulonephritis--Immunological aspects-
Congresses. 2. Autoantibodies--Congresses. 3. Cryo
globulins--Congresses. 4. Cryoglobulinemia--Congresses.
I. Ponticelli, Claudio. II. Minetti, Luigi.
III. D'Amico, G. (Guiseppe) IV. Title. V. Series.
RC918.G55I58 1985 616.6'12 86-8549
Copyright
© 1986 by Martinus Nijhoff Publishers, Dordrecht.
Softcover reprint of the hardcover 1s t edition 1986
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishers,
Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht,
The Netherlands.
v
Contents
List of First Authors
IX
Introduction
RJ. Glassock
Part I. PHYSIOLOGY AND PATHOLOGY OF ANTIGLOBULINS
1. Subsets of Rheumatoid Factors Determined by Cross Idiotypes
v. Agnello ...................... 7
2. Structure and Function of Rheumatoid Factors: Implication For
Its Role in The Pathogenesis of Mixed Cryoglobulinemia
R.D. Goldfien, S. Fong, P. Chen and D.A. Carson ..... 17
3. Regulatory Idiotypes and Diseases
c.A. Bona 29
Discussion 36
Part II. ROLE OF ANTI GLOBULINS IN EXPERIMENTAL
GLOMERULONEPHRITIS
4. Pathogenetic Mechanisms of Infective Endocarditis Glomerulon
ephritis in The Rabbit
P. Naish ....................... 43
5. Interactions of Human IgM Rheumatoid Factors With Immune
Complexes in Experimental Murine Glomerulonephritis
P.M. Ford . . . . . . . . . . . . . . . . . . . . . .. 53
6. Anti-Idiotypic Antibodies in Glomerulonephritis and in Tubulo
interstitial ~Nephritis Models in Immune Renal Injury
c.B. Wilson, K.M. Bannister, F. Mampaso, T. Ulich and M.
Zanetti ........................ 67
VI
7. Experimental Analysis of The Generation of Pathogenic Immune
Complexes Resulting From Immunoglobulin Interactions
P.H. Lambert, S. Izui, Y. Gyotoku, M. Abdelmoula and F. Sper
tini . 79
Discussion 86
Part III. CLASSIFICATION OF CRYOGLOBULINS
AND BIOCHEMICAL FACTORS INDUCING
CRYOPRECIPITATION
8. Classification of Cryoglobulinemias
C Zanussi, F. Invemizzi and P.L. Meroni . . . . . . . 95
9. Intrinsic Properties Inducing Precipitation of Cryoglobulins
A.C Wang, I.y. Wang .............. . 101
10. Cryoprecipitation as a Consequence of Globulin-Antiglobulin
Interactions
G.N. Abraham, S.L. Johnston, CG. Hall, CD. Scoville and D.N.
Podell ....................... . 113
11. Fibronectin Is a Regular Component of Single-Type and Mixed
Cryoglo bulins
F. Dalmacco and G. Gallo 119
Discussion 128
Part IV. IMMUNOLOGICAL ASPECTS OF ESSENTIAL
MIXED CRYOGLOBULINEMIA
12. Complement Activation in Patients With Mixed Cryoglobuli
nemia
I. Gigli 135
13. Human Type II Mixed Cryoglobulins as a Model of Idiotypic
Interactions
J.C Renversez, S. Roussel, MJ. Valle and P.H. Lambert 147
14. Monoclonal Antibodies to Idiotypic Determinants on Monoclon
al Rheumatoid Factors
M. Ono, CG. Winearls, D. Grennan, D.K. Peters and J.P.G.
Sis sons 161
Discussion 171
VII
Part V. CLINICAL AND MORPHOLOGICAL FINDINGS IN
ESSENTIAL MIXED CRYOGLOBULINEMIA
15. Mixed Cryoglobulinemia: An Update of Recent Clinical Experi
ence
P.D. Gorevic 179
16. Histological and Himmunohistological Features in' Essential
Mixed Cryoglobulinemia Glomerulonephritis
F. Ferrario, G. Colasanti, G. Barbiano di Belgiojoso, G. Banfi, R.
Campise, R. Confalonieri and G. D'Amico ........ 193
17. Clinical and Histological Correlations in Essential Mixed Cryo
globulinemia (EMC) Glomerulonephritis
G. Barbiano di Be1giojoso, A. Montoli, A. Tarantino, F. Ferrario,
P. Maldifassi, A. Baldassari and L. Minetti . . . . .. 203
18. Ultrastructural Features in Glomerulonephritis in Essential
Mixed Cryoglobulinemia
MJ. Mihatsch and G. Banfi . . . . . . . . . . . . . .. 211
19. Prognostic Factors in Essential Mixed Cryoglobulinemia Neph
ropathy
A. Tarantino, G. Montagnino, A. Baldassari, G. Barbiano Di
Belgiojoso, G. Colasanti, A. Montoli, A. Bucci and C. Ponticelli 219
Discussion 226
Part VI. DIFFERENT THERAPEUTIC REGIMENS IN THE
MANAGEMENT OF EMC PATIENTS
20. Long-Term Management of Essential Mixed Cryoglobulinemia
DJ. Cordonnier, P. Vialtel, E. Dechelette, F. Bayle, J.L. Alix,
J.P. Vinollez, F. Kuentz and E. Borrel ....... 237
21. Effects of Cryoapheresis on Plasma Cryoglobulins and Renal
Function in Patients With EMC Glomerulonephritis
Q. Maggiore, A. L'Abbate, C. Bartolomeo and S. Gutrupi 251
22. Treatment of Renal Disease in Essential Mixed Cryoglobulinemia
C. Ponticelli, G. Montagnino, R. Campise, A. Baldassari and A.
Tarantino .................... 265
23. Long Term Treatment of Mixed Cryoglobulinemia (MCG)
D. GeItner 273
Discussion 287
Concluding remarks
J.S. Cameron 291
Index 301
List of First Authors
George N. ABRAHAM, The University of Rochester, Medical Center, De
partment of Medicine, Clinical Immunology. Rheumatology Unit, 601
Elmwood Avenue, BOX 695, Rochester, New York 14642 (USA).
Vincent AGNELLO, Lahey Clinic Medical Center, Immunology Laboratory,
41 Mall Road, Burlington, Massachussetts 01805 (USA).
Giovanni BARBIANO DI BELGIOJOSO, Divisione di Nefrologia e Dialisi,
Ospedale Ca Granda, Piazza Ospedale Maggiore 3, 20162 Milano (Ita
ly).
Constantin A. BONA, The Mount Sinai Medical Center, One Gustave L.
Levy Place, New York, N.Y. 10029 (USA).
Dennis A. CARSON, Department of Basic and Clinical Research, Scripps
Clinic and Research Foundation, 10666 North Torrey Pines Road, La
Jolla, California 92037 (USA).
Stewart J. CAMERON, Clinical Science Laboratories, Guy's Tower (17th &
18th Floors), Guy's Hospital, London Bridge SE1 9RT (UK).
Daniel CORDONNIER, Centre Hospitalier Regional et Universitaire de Gre
noble, Department of Nephrology, B.P. 217 X, 38043 Grenoble Cedex
(France).
Franco DAMMACCO, Institute of Medical Pathology, University of Bari,
Medical School, 7012 Bari (Italy).
Franco FERRARIO, Ospedale Provinciale 'S. Carlo Borromeo', Divisione di
Nefrologia e Dialisi, Via S. Pio II, 3, 20153 Milano (Italy).
Peter M. FORD, Queen's University, Rheumatic Diseases Unit, 26 Barrie
Street, Kingston, Ontario, K7L 316 (Canada).
David GELTNER, Kaplan Hospital, Department Internal Medicine, P.O.B. 1,
Rehovot (Israel).
Irma GIGLI, UCSD Medical Center, Division of Dermatology, 225 Dickin
son Street, San Diego, California 92103 (USA).
Richard J. GLASSOCK, Department of Medicine, Lac Harbor - UCLA
Medical Center, 1000 Carson Stret, Torrance, California 90509 (USA).
x
Peter D. GORE VIC, Division of Allergy, Rheumatology, and Clinical Immu
nology, Health Sciences Center, State University of New York at Stony
Brook, Stony Brook, New York 11794 (USA).
Franco INVERNIZZI, Clinica Medica II, Ospedale Maggiore - Universita di
Milano, Via Francesco Sforza 35, 20122 Milano (Italy).
Paul H. LAMBERT, WHO Immunology Research and Training Centre, De
partment of Pathology, Centre Medical Universitaire, 1 Rue Michel Ser
vet, 1211 Geneva 4 (CH).
Quirino MAGGIORE, Divisione di Nefrologia 'G. Monasterio', Ospedale
Regiona1e, ViaSbarre Inferiori 39, 89100 Reggio Calabria (Italy).
Michael 1. MIHATSCH, Institut Fur Pathologie der Universitat, Schonbeis
trasse 40, 4056 Basel (CH).
Patrick NAISH, North Staffordshire Royal Infirmary, Princes Road, Hart
shill, Stoke-on Trent ST47LN (UK).
Claudio PONTICELLI, Divisione di Nefrologia e Dialisi, Ospedale Maggiore,
Via Commenda 15, 20122 Milano (Italy).
Jean Charles RENVERSEZ, Centre Hospitalier Regional et Universitaire, Bio
chimie Medicale - A, Proteins et Lipides, B.P. 217 X, Grenoble Cedex
38043 (France).
Patrick 1.G. SISSONS, Royal Postgraduate Medical School, Hammersmith
Hospital, Ducane Road, London W12 OHS (UK).
Antonio TARANTINO, Divisione di Nefrologia e Dialisi, Ospedale Maggiore,
Via Commenda 15, 20122 Milano (Italy).
An-Chuan WANG, Medical University of South Carolina, Department of
Basic and Clinical Immunology and Microbiology, 171 Ashley Avenue,
Charleston, South Carolina 29425 (USA).
Curtis B. WILSON, Department of Immunology, Research Institute of
Scripps Clinic, 10666 North Torrey Pines Road, La Jolla, California
92037 (USA).
Introduction
RICHARD J. GLASSOCK
Introducing a scientific symposium is an uncertain and difficult task. The
remarks must not be too specific lest the participant's later contributions be
intruded upon, yet an overview of the goals and objectives of the conference
should be presented in an inquisitive and stimulating fashion. Perhaps a
compromise position would be to make a few general statements and pose a
limited number of questions which hopefully would then be addressed dur
ing the formal or informal portions of the meeting. A conclusion incorpo
rating some perspectives of the relevance of the specific topic to the more
global issues of disease and its consequences might be appropriate.
The goals and objectives of this conference, as set forth by its organizers,
Professors Ponti celli, D'Amico and Minetti, are rather simple and straight
forward; namely, to review and elucidate the immunopathophysiology of
cryoimmunoglobulins and auto-antibodies to immunoglobulins (lg) and,
secondarily, to explore the possible participation of these disordered states
in glomerular injury. As such, this conference is principally devoted to an
analysis of two properties of certain species of the globulin fraction of serum
proteins, specifically the ability to self associate on the basis of immune
interactions and to form insoluble aggregates when exposed to reduced
ambient temperature. As we shall see, these two properties are often dis
tinctly related.
Session I will appropriately deal with fundamental aspects of the first
property, focusing on the auto-antibodies formed to C-terminal half of the
Cy2 domain ofIg (Rheumatoid Factors) [1] and autoantibodies to the vari
able, antigen combining, sites of Ig (anti-idiotypic antibodies) [2]. That
autoantibodies to specific topographic sites on normal or altered Ig mole
cules occur in health and disease has been recognized since the first descrip
tion of rheumatoid factors by Waaler in 1940 [3]. Since virtually the entire
topographic surface of a protein molecule is potentially capable of eliciting a
specific antibody response [4], it is perhaps surprising that only certain
domains of the Ig molecule have a propensity to evoke an antibody