Antibodies to the basal membrane of glomeruli in serum
In the norm of AT to the basal membrane, glomeruli in the serum are absent.
The presence of AT to the basal membrane of the glomeruli( anti-BMC) is most typical for patients with fast-progressive glomerulonephritis( anti-BMC glomerulonephritis).All patients with anti-BMC glomerulonephritis can be divided into two groups: only with kidney pathology and Goodpasture's disease( 50%), in which the latter is combined with pulmonary.
Arg for the formation of anti-BMC is the C-terminal portion of the a3-chain of type IV collagen, which is a component of the glomerular basement membrane( Ag Goodpasture).Currently, there are many methods for determining anti-BMP - indirect immunofluorescence, ELISA( most available), RIA.
Anti-BMC is found in 90-95% of patients with Goodpasture's syndrome. In most patients with active anti-BMC glomerulonephritis
, the anti-BMP content is higher than 100 U.With effective treatment, the level of anti-BMD decreases and they can disappear after 3-6 months. In a number of patients with rapidly progressive glomerulonephritis, anti-BMC and antinuclear antibodies( up to 40% of patients) are present in the blood. Typically, this combination indicates a relatively favorable prognosis [Henry J. B., 1996].Approximately 70% of patients with anti-BMC glomerulonephritis have AT to the basal membrane of the renal tubules, which cause a parallel development of tubulointerstitial nephritis.
Goodpasture syndrome is a rare disease, characterized by a simultaneous rapid progressive kidney and lung disease( pulmonary-kidney syndrome) and associated with the formation of anti-BMC, necessarily giving a cross reaction with the Ar basement membrane of the pulmonary alveoli( contain the epitope of type IV collagen).Men are more often ill at the age of 10-50 years. Anti-BMC is detected in more than 90% of patients with Goodpasture's syndrome. The titer of anti-BMC correlates with the activity of the process, therefore it is used to monitor the effectiveness of the treatment.
Anti-BMC in the serum is sometimes found in patients with other forms of glomerulonephritis.
The determination of AT to the basal membrane of glomeruli, the cytoplasm of neutrophils, as well as antinuclear AT and CEC is shown to all patients with primary fast-progressive glomerulonephritis.