Pathogenesis of poststreptococcal glomerulonephritis a century after Clemens von Pirquet.
Considerable insight has been gained into the etiopathogenesis of poststreptococcal glomerulonephritis since the landmark theoretical construct of Clemens von Pirquet postulated that disease-causing immune complexes were responsible for the nephritis that followed scarlet fever. Over the years, molecular mimicry between streptococcal products and renal components, autoimmune reactivity and several streptococcal antigens have been extensively studied. Recent investigations assign a critical role to both in situ formation and deposition of circulating immune complexes that would trigger a variety of effector mechanisms. Glomerular plasmin-binding activity of streptococcal glyceraldehyde-3-phosphate-dehydrogenase may play a role in nephritogenicity and streptococcal pyrogenic exotoxin B and its zymogen precursor may be the long-sought nephritogenic antigen.
Rodríguez-Iturbe
B
B
Instituto Venezolano de Investigaciones Científicas (IVIC-Zulia), Hospital Universitario de Maracaibo, Centro de Investigaciones Biomédicas, Maracaibo, Venezuela. bernardori@telcel.net.ve
Batsford
S
S
D000818:Animals; D001426:Bacterial Proteins / Q000276:immunology; D005098:Exotoxins / Q000276:immunology; D005341:Fibrinolysin / Q000378:metabolism; D005921:Glomerulonephritis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases / Q000276:immunology; D006801:Humans; D007678:Kidney Glomerulus / Q000378:metabolism; D018448:Models, Immunological; D018716:Molecular Mimicry; D012541:Scarlet Fever / Q000276:immunology; D013290:Streptococcal Infections / Q000150:complications / Q000276:immunology* / Q000473:pathology; D013297:Streptococcus pyogenes / Q000737:chemistry / Q000472:pathogenicity
D001426:Bacterial Proteins; D005098:Exotoxins; C027951:erythrogenic toxin; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases; D005341:Fibrinolysin