[Role of hemostasis in the formation of crescents in extracapillary glomerulonephritis].
Extracapillary glomerulonephritis are associated with fibrin deposition in the urinary space of the glomerulus. Such deposits were correlated with the severity of the disease and with a poor renal outcome. Fibrin formation involves an activation of the coagulation cascade either through the intrinsic pathway, Hageman factor being activated by the altered glomerular basement membrane, either by the extrinsic pathway, infiltrating monocytes and glomerular cells exhibiting a procoagulant activity i.e. thromboplastin or tissue factor. Treatments with heparin or warfarin were shown to decrease the severity of experimental glomerular diseases. A similar beneficial effect was obtained with a monocyte-depleting serum and more recently with a treatment by a tissue type plasminogen activator. Glomerular cells also produce a fibrinolytic activity which could be too low or uneffective on extracapillary fibrin deposits if they contain high amounts of plasminogen activator inhibitors. Thrombin has procoagulant activity, antifibrinolytic activity and has cellular chemotactic and proliferative effects. It could play a major role in the pathogenesis of crescent formation.
Rondeau
E
E
Service de Néphrologie A, Hôpital Tenon, Paris.
Nguyen
G
G
Adida
C
C
Peraldi
M N
MN
Kanfer
A
A
Sraer
J D
JD
D000818:Animals; D005337:Fibrin / Q000378:metabolism; D005921:Glomerulonephritis / Q000097:blood* / Q000473:pathology; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology; D013917:Thrombin / Q000502:physiology
D005337:Fibrin; D013917:Thrombin
Rôle de l'hémostase dans la formation de croissants au cours des glomérulonéphrites extracapillaires.