To the Editor.—
IgA nephropathy is recognized as the most common form of glomerulonephritis, with variable distribution in different geographic regions.1 Clinical and experimental data1 indicate an immune complex (IC)-mediated pathogenesis of the renal damage.Circulating IgA-IC, found in one third of patients, or in situ formation of these ICs seems to play a relevant role together with IgG and/or IgM complement and fibrinogen deposits in the glomeruli.1Site of production and specificity of glomerular deposits are largely unknown. Viral and dietary macromolecular antigens crossing the mucosal barrier of the gut elicit a predominantly IgA response,1-4 while an impaired clearance of IC might contribute to glomerular deposition of nephritogenic factors.2 In a previous work,5 a low-antigen-content (LAC) diet was able to modify the main clinical and serologic parameters of mixed cryoglobulinemia, a typical IC disease, chiefly by a functional restoration of the mononuclear phagocytic
Ferri C, Puccini R, Paleologo G, Longombardo G, Migliorini P, Moriconi L. IgA Nephropathy: Preliminary Results of Low-Antigen—Content Diet Treatment. Arch Intern Med. 1992;152(2):429–438. doi:10.1001/archinte.1992.00400140157045
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