The secretory immune system and renal disease.

An immunopathological analysis of renal tissue from 105 patients was undertaken: (1) to clarify the relationship of the secretory immune system to renal diseases in which glomerular deposits of immunoglobulin A, (alpha chain), occurred; (2) to determine the lower nephron localization of secretory component and alpha chain in renal disease. This study, which included twenty-four patients with glomerular deposits of alpha chain, failed to reveal glomerular localization of secretory IgA. Secretory component was not found in renal tubular cells in kidneys with normal or minimally abnormal renal histology. In contradistinction to these findings, significant amounts of secretory component were found in tubular epithelial cells and casts in tissue from fifty-one patients with morphological evidence of significant renal damage; this localization had no correlation with glomerular deposits of IgA, IgM or other immunoreactants. Alpha Chain was rarely found in the tubular epithelium or in interstitial round cells; fifteen patients had alpha chain in casts. We conclude that the glomerular localization of immunoglobulin in glomerulonephritis is not derived from the secretory immune system, and the IgA present in glomeruli is not secretory IgA. The finding of secretory component in tubular cells in diseased kidneys without alpha chain may support an hypothesis for an independent role for secretory component in renal disease, apart from its function in the transport and stabilization of secretory IgA.