Immunofluorescence Staining for IgG Subclass: Cause for Discrepancy in the Detection of IgG1

Satoru Kudose; Miroslav Sekulic; Vighnesh Walavalkar; Ibrahim Batal; M Barry Stokes; Glen S Markowitz; Vivette D D'Agati; Dominick Santoriello

doi:10.1016/j.ekir.2023.08.015

Immunofluorescence Staining for IgG Subclass: Cause for Discrepancy in the Detection of IgG1

Kidney Int Rep. 2023 Aug 21;8(11):2416-2420. doi: 10.1016/j.ekir.2023.08.015. eCollection 2023 Nov.

Authors

Satoru Kudose¹, Miroslav Sekulic¹, Vighnesh Walavalkar², Ibrahim Batal¹, M Barry Stokes¹, Glen S Markowitz¹, Vivette D D'Agati¹, Dominick Santoriello¹

Affiliations

¹ Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA.
² Department of Pathology and Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.

Abstract

Introduction: Immunofluorescence (IF) staining for IgG subclasses plays an important role in the classification of kidney disease. However, widely used IgG subclass-specific antibodies are now commercially unavailable. Thus, we compared alternative antibodies for performing IgG subclass staining.

Methods: A total of 21 cases were stained by 3 different methods: direct IF using fluorescein isothiocyanate (FITC)-conjugated polyclonal antibodies against IgG1-4 (commercially unavailable method), direct IF using FITC-conjugated monoclonal antibodies (clones HP-6091, 6014, 6050, and 6025), indirect IF using monoclonal antibodies (clones HP-6069, 6002, 6050, and 6025), and FITC-conjugated polyclonal secondary antibody. For cases with discrepancy in IgG1 staining, additional direct IF using FITC-conjugated monoclonal antibody (clone 4E3) was performed.

Results: Of 21 cases, 11 (52%) had no staining for IgG1 by direct IF using the clone HP-6091 despite ≥1+ staining by the direct IF using polyclonal antibodies. Similarly, direct IF for IgG1 using the clone 4E3 had negative result in all 10 cases with available tissue. However, indirect IF for IgG1 using the clone HP-6069 had similar staining intensity (within 1 order of magnitude) as direct IF using the polyclonal antibodies (10 of 10). Results of IF for IgG2, IgG3, and IgG4 were similar in most cases.

Conclusion: The choice of antibodies influences the result of IgG subclass staining, especially for anti-IgG1 antibodies, in which 2 monoclonal antibodies (HP6091 and 4E3) appear less sensitive. Although this may be due to unaccounted variables and requires confirmation, our results may partially explain the difference in IgG1 staining in the literature and underscore the need for careful validation.

Keywords: IgG subclass; immunofluorescence; kidney biopsy; monoclonal gammopathy of renal significance.