Impaired IgG response to tetanus toxoid in human membranous nephropathy: association with HLA-DR3

The IgG response to tetanus toxoid (TT) immunization was quantitated by by radioimmunoassay in patients with membranous nephropathy (MN) and healthy controls. Variation in subclass (ELISA) and electrical charge (isoelectric focussing, immunofixation & autoradiography) of the IgG response were also assessed. Total IgG and igG subclass responses were impaired in MN compared to controls, although this was only significant for IgG-3 (P less than 0 X 05). Non responders to TT were more common in MN, and response was independent of disease activity. No distinctive pattern of IgG subclass response or IgG spectrotype was seen in MN. Impaired response to TT was associated with HLA-DR3 among controls, and in MN (88 X 8% of whom were DR3) markedly depressed responses occurred in apparent DR3 homozygotes.