Nephrology Congress 2027

IgA nephropathy (IgAN) is an autoimmune disease in which IgA of unique molecular properties forms immune complexes (IC) with corresponding IgG antibodies which are present in the circulation and in mesangial deposits leading to the impairment of renal function. Importantly, molecular properties of IgA in IC and mesangial deposits are identical to those of IgA produced by EBV-infected plasma cells including the restriction to the IgA1subclass, the polymeric form with J chain, deficiency of galactose in the O-linked glycan side chains in the hinge region of heavy chains, and preferential association with lambda light chains. In view of the physiological IgA deficiency in childhood and early infection with EBV in socio-economically disadvantaged countries, the ensuing immune responses protect these children from the later development of IgAN. These findings also contribute to the remarkable geographical and racial differences in the incidence of IgAN in various countries and continents. We propose that in addition to plausible genetic differences, the very early EBV infection occurring in economically underdeveloped countries at the time of physiological IgA system immaturity in children prevents IgAN in such populations while it occurs dominantly in adolescence in socio-economically developed countries.

J. Mestecky completed his MD at Charles University and PhD at the Academy of Sciences in Prague, Czech Republic. He obtained honorary doctorate degrees from Denmark, Sweden and the Czech Republic. He is a Professor of Microbiology and Medicine at the University of Alabama at Birmingham. He has published 605 papers in respected journals and served as a co-author and editor of 16 books focusing on mucosal immunology and published by Elsevier/Academic Press and Plenum Press.