Dirofilaria immitis. 5. Immunopathology of filarial nephropathy in dogs.

Fourteen beagles infected with larvae (microfilariae) of Dirofilaria immitis, were randomly selected from another study in which the toxic effects of subfilaricidal doses of diethylcarbamazine were being evaluated. This group of 14 dogs, together with 4 uninfected control animals, were variably sacrificed between 14 and 25 months after larval inoculations, and the ensuing renal lesions were studied by light and ultrastructural microscopy and by immunofluorescence and antibody elution techniques. On the basis of these studies, two groups of animals were distinguished. The first group was characterized by a striking pattern of linear fluorescence and fine ultrastructural dense deposits along the glomerular basement membrane, poor antibody response, and an inability to clear microfilariae from the tissues and circulation. The second group, with a nonlinear pattern of fluorescence, was characterized by a strong immune response, efficient elimination of microfilariae, and immunofluorescence and ultrastructural evidence of predominantly mesangiopathic immune complex renal disease. In both groups, elution studies demonstrated tissue deposits of antiworm antibodies, suggesting a filaria-antibody immune-complex nephropathy. No evidence was found for the presence of anti-basement-membrane antibodies. On the basis of a previous experimental model, it is postulated that in the first group of animals with linear fluorescence, the observed lesions may represent a natural form of an immunopathogenic mechanism of glomerular damage in which filarial antigen becomes uniformly localized in the glomerulus and elicits an autologous antibody response. The possible role of the drug diethylcarbamazine in inducing this mechanism of immune injury is discussed.