ROLE OF GAMMA GLOBULINS IN PATHOGENESIS OF RENAL LESIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS AND CHRONIC MEMBRANOUS GLOMERULONEPHRITIS, WITH AN OBSERVATION ON THE LUPUS ERYTHEMATOSUS CELL REACTION

Abstract

Utilizing the fluorescent antibody method for the histologic demonstration of localized gamma-globulins, the following observations (in contradiction to the lack of such findings in a variety of normal and pathologic, control kidneys) are reported. In systemic lupus erythematosus, gamma-globulins were localized in the thickened capillary walls, the "wire-loop" lesions, and the so called "hyaline thrombi" in glomeruli; these sites of localization of gamma-globulins correlated with the pattern of accentuated eosinophilia of the glomeruli, as seen in hematoxylin-eosin sections, or with the pattern of PAS-positive areas in the glomeruii in sections stained with the periodic acid-Schiff reaction; and gamma-globulins were localized rarely in large cytoplasmic granules in tubular epithelium and occasionally in glomerular capsular crescents, tubular protein casts, and inflammatory cells, particularly in the cytoplasm of cells identified as immature and mature plasma cells. In nephrotic glomerulonephritis gamma-globulins were localized in the glomerular basement membrane and appertaining structures in chronic membranous glomerulonephritis; in the altered mesangium in chronic lobular glomerulonephritis; and in the tubular protein casts, in a lesser concentration and other serum proteins in a greater concentration than found in the glomeruli. In positive lupus erythematosus preparations the nuclei of leukocytes, while undergoing transformation and subsequent phagocytosis to form lupus erythematosus cells, were the sites of localization of gamma-globulin whereas in control preparations there was no nuclear localization.