[Pathogenesis of immune glomerulonephritis].
Immune glomerulonephritis (GN) initially develop as a result of inappropriate immune response, either inadequately directed to self-antigens, or unable to effectively eliminate a foreign antigen. This abnormal immune response leads to the formation of circulating immune complexes, auto-antibodies or self-reactive effector T cells that target glomerular antigens or to the inappropriate regulation of IgA producing lymphocytes (Berger disease) or helper T lymphocyte sub populations (minimal change nephrotic syndrome). In most of the cases, the initial immune injury induces an inflammatory response. However, it is the extent of the interstitial fibrosis which is genetically controlled, that conditioned the evolution of the initial glomerular injury to glomerular sclerosis and progressive renal failure. Recent data on the pathogenesis of the most frequent GN are reported: IgA nephropathy, membranous nephropathy and minimal change nephrotic syndrome. Recent significant advances in the pathophysiology of those glomerular diseases have shed considerable light on the understanding of the underlying disease even if they do not have immediate therapeutic implications.
Rougier
Jean-Philippe
JP
Service de néphrologie B, hôpital Tenon, 75970 Paris Cedex 20. jean-philippe.rougier@tnn.ap-hop-paris.fr
Ronco
Pierre
P
D000818:Animals; D000936:Antigen-Antibody Complex / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D004195:Disease Models, Animal; D005921:Glomerulonephritis / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology; D015433:Glomerulonephritis, Membranous / Q000276:immunology / Q000503:physiopathology; D005923:Glomerulosclerosis, Focal Segmental / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D007676:Kidney Failure, Chronic / Q000209:etiology; D007678:Kidney Glomerulus / Q000276:immunology; D016030:Kidney Transplantation; D016131:Lymphocyte Subsets / Q000276:immunology; D009402:Nephrosis, Lipoid / Q000276:immunology / Q000503:physiopathology; D009404:Nephrotic Syndrome / Q000209:etiology / Q000276:immunology / Q000503:physiopathology; D011817:Rabbits; D051381:Rats; D012008:Recurrence; D013601:T-Lymphocytes / Q000276:immunology
D000936:Antigen-Antibody Complex; D001323:Autoantibodies; D007136:Immunoglobulins