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Antibodies to the basal membrane of the glomeruli in the blood
Last reviewed: 23.04.2024
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Normally, there are no antibodies to the basal membrane of the glomeruli in the blood serum.
The presence of antibodies 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.
Antigens to produce anti-BMA is the C-terminal portion of α 3 -chain type IV collagen, which is a component of the glomerular basement membrane (Goodpasture Ar). 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 above 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-BMP and antinuclear antibodies (up to 40% of patients) are present in the blood. Usually this combination indicates a relatively favorable forecast. Approximately 70% of patients with anti-BMC glomerulonephritis have antibodies to the basal membrane of the renal tubules, which cause a parallel development of tubulointerstitial nephritis.
Goodpasture syndrome is a rare disease characterized by simultaneous rapid progressive damage of the kidneys and lungs (pulmonary-kidney syndrome) and associated with the formation of anti-BMC, necessarily giving a cross reaction with the basement membrane antigens of the pulmonary alveoli (contain type IV collagen epitope). 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.
Determination of antibodies to the basal membrane of the glomeruli, neutrophil cytoplasm as well as antinuclear antibodies and CEC is shown to all patients with primary fast-progressive glomerulonephritis.
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