Evaluation of immunoglobulin A1/immunoglobulin A2 ratio and B cell lymphoma-6 in relation to apoptosis-associated speck-like protein in diabetic kidney disease patients.

[BACKGROUND] Inflammation and alteration of the immune system play a key role in the pathogenesis of diabetes mellitus (DM). However, little is known about the underlying mechanisms involved in the inflammatory pathways of diabetic kidney disease (DKD). We aimed in this study to evaluate immunoglobulin A (IgA) subclasses/ratio and B cell lymphoma-6 (BCL-6) in relation to inflammasome adaptor protein ASC (apoptosis-associated speck-like protein containing a caspase activation and recruiting domain) in diabetic patients with and without kidney disease. The present study was conducted on 50 diabetic patients who were classified into 25 patients without kidney disease and 25 DKD patients, together with 25 age-matched healthy individuals. Enzyme-linked immunosorbent assay (ELISA) was used to assess ASC and BCL-6 levels in culture supernatants of peripheral blood mononuclear cells as well as to determine IgA1 and IgA2 levels in individuals' serum.

[RESULTS] The results revealed a significant increase in ASC levels together with a significant decrease in IgA1 and BCL-6 levels in DKD patients compared to other groups. A significant association was observed between the IgA1/ IgA2 ratio and improved disease markers in all patients. In addition, ASC levels were negatively correlated with both IgA2 and BCL-6 levels.

[CONCLUSIONS] It can be concluded that altered IgA subtypes and its ratio (IgA1/IgA2) as well as BCL-6 may be involved in the pathogenesis of DKD, suggesting their future therapeutic potential in DKD patients.