Rheumatology Medical News about Lupus, Kidney, Glomerulonephritis

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Pathogenesis of kidney disease in systemic lupus erythematosus
Current Opinion in Rheumatology, 08/18/09

Bagavant H et al. - Lupus glomerulonephritis is a prototype of immune complex disease mediated by autoantibodies of multiple specificities, one of which is anti-DNA. In addition to systemic autoimmunity, end-organ responses, and end-organ resistance to damage are also critical in determining disease outcome. This understanding might facilitate in the design of novel therapeutic approaches for systemic lupus erythematosus (SLE).

Methods

Review to discuss recent literature on pathogenetic mechanisms of lupus glomerulonephritis

Results

Characteristic features of lupus glomerulonephritis:
- Glomerular immune complexes AND
- Autoantibodies of multiple specificities
  participate in the formation of immune complexes, deposited in the kidneys
  Renal infiltration by T cells,
  macrophages, and dendritic cells
  have a dominant role in the progression, leading to renal failure
  Activation of Toll-like receptors modulates autoantibody production and systemic interferon responses
  However, glomerular cell responses to immune injury influence disease outcome
New insights on the genetics of susceptibility to end-organ damage:
- Gene expression profiles during disease progression provide potential markers for diagnosis of lupus glomerulonephritis progression and flares
- Studies of end-organ responses provide new targets for therapeutic interventions