Cell-mediated and humoral immunity to streptococcal cell wall antigenic extract in patients with glomerulonephritis and in healthy controls.

Cell-mediated immunity of lymphocytes to group A, type T 12, streptococcal cell wall extract was evaluated by measurement of DNA synthesis in cultures of lymphocytes from healthy controls and from glomerulonephritic patients. Cells from adult healthy persons regularly responded to this antigen, whereas cord blood lymphocytes did not. Several additional experiments suggested that the response in normal controls was due to a specific immune response and was not caused by a nonspecific mitogenic effect of the cell wall antigens. In a group of 17 patients with progressive glomerulonephritis (PGN) and 10 with nonprogressive glomerulonephritis (IRGN) the level of response was comparable to that of healthy controls. In the PGN group the response was significantly lower after 4 days, but this difference disappeared after 6 days. Thus, this method failed to differentiate between health and disease. The presence of anti-streptococcal cell wall antigen antibodies was tested using a passive hemagglutination technique. Only 1 of 6 controls had a demonstrable antibody titer, whereas 15 of 26 nephritic patients had detectable antibodies and 10 of them had titers greater than 1/64. Our findings suggest the possibility of a relationship between streptococcal bacteria and progressive glomerulonephritis.