title: The Pathogenesis and Therapeutic Implications of Tubulointerstitial Inflammation in Human Lupus Nephritis.
abstract: Nephritis is a common complication of systemic lupus erythematosus for which current therapies often prove inadequate. Current lupus nephritis classification systems emphasize glomerular acuity and scarring. However, tubulointerstitial inflammation (TII) and scarring are much better predictors of progression to renal failure. It now is becoming clear that the immunologic features, and probable underlying mechanisms, are very different in lupus glomerulonephritis and TII at the time of biopsy. Although glomerulonephritis is a manifestation of systemic autoimmunity, TII is associated with local in situ adaptive immune cell networks predicted to amplify local inflammation and tissue damage. In addition, poorly defined networks of innate immune cells and effectors likely contribute to the severity of local inflammation. Defining these in situ immune mechanisms should lead to a better understanding of prognostically meaningful lupus nephritis subsets and show novel therapeutic opportunities.
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL; Department of Pathology, University of Chicago, Chicago, IL; Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, Chicago, IL. Electronic address: mclark@uchicago.edu.
authors.forename: Marcus R
authors.initials: MR
authors.lastname: Clark
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Trotter
authors.affiliation: Department of Pathology, University of Chicago, Chicago, IL.
authors.forename: Anthony
authors.initials: A
authors.lastname: Chang
mesh_terms: D056704:Adaptive Immunity / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology*; D005921:Glomerulonephritis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation; D007668:Kidney / Q000276:immunology* / Q000473:pathology; D008181:Lupus Nephritis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D009395:Nephritis, Interstitial / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents
keywords: Lupus nephritis; adaptive immunity; innate immunity; tubulointerstitial inflammation