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2015 ; 35
(5
): 455-64
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gab.com Text
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The Pathogenesis and Therapeutic Implications of Tubulointerstitial Inflammation
in Human Lupus Nephritis
#MMPMID26573548
Clark MR
; Trotter K
; Chang A
Semin Nephrol
2015[Sep]; 35
(5
): 455-64
PMID26573548
show ga
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.