Skip to main content
SpringerLink
Log in

Immunopathology of Tubulo-Interstitial Nephritis in Man and in Experimental Animals

  • Chapter
Advances in Nephrourology

Part of the book series: Ettore Majorana International Science Series ((PHYSC,volume 9))

  • 75 Accesses

Abstract

It is generally acknowledged that many forms of glomerular diseases are antibody-mediated, either as a result of deposition of circulating immune complexes or due to anti-glomerular basement membrane antibodies. Until recently little consideration was given to the possibility that there might be comparable forms of diseases involving other parts of the kidney. However, there is now clear evidence, obtained both in experimental models and human disease, that tubular and interstitial lesions can result from deposition or local formation of immune complexes or because of antibodies directed against tubular basement membranes or against the brush border of proximal convoluted tubules. Moreover, it appears that the renal interstitium is a site where cell-mediated reactions may occur, accounting for some forms of interstitial nephritis.

We shall discuss in sequence experimental models of immunologically-mediated tubular and interstitial renal diseases and the evidence concerning the occurrence and probable significance of corresponding lesions in man.

This Work was supported by the Deparment of Health, Education and Welfare, United States Public Health Service, H.I.C. Grant AI-10334.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Andres, G. A., Accinni, L., Hsu, K.C., Penn, I., Porter, K.A., Randall, J.M., Seegal, B. C. and Starzl, T.E.: Human renal transplants. III. Immunopathologic studies. Lab. Invest. 22: 588–604, (1970).

    Google Scholar 

  2. Andres, G.A., Albini, B. and Ossi, E.: Pathogenesis, diagnosis, prognosis and treatment of immunologically mediated tubulo- interstitial nephritis. In: Prevention of Kidney and Urinary Tract Diseases, Fogarty International Center Series on Preventive Medicine., Coggins, C.H. and Cummings, W.B., eds. Vol. 5, pp. 251–262 (DHEW, NIH, Bethesda, 1978).

    Google Scholar 

  3. Andres, G.A., Brentjens, J. Kohli, R., Anthone, R., Anthone, S., Baliah, T., Montes, M., Mookerjee, B., Prezyna, A., Sepulveda, M., Venuto, T. and Elwood, C.: Histology of human tubulo- interstitial nephritis associated with antibodies to renal basement membranes. Kidney Int. 13: 480–491, (1978).

    Article  Google Scholar 

  4. Andres, G.A. and McCluskey, R.T.: Tubular and interstitial renal disease due to immunologic mechanisms. Kidney Int. 7: 271–289, (1975).

    Article  Google Scholar 

  5. Baldwin, D.S., Levine, B.B., McCluskey, R.T. and Gallo, G.R.: Renal failure and interstitial nephritis due to penicillin and methicillin. New Engl. J. Med. 279: 1245–1252, (1968).

    Article  Google Scholar 

  6. Bergstein, J. and Litman, N.: Interstitial nephritis with anti- tubular basement membrane antibody. New Eng. J. Med. 292: 875–878, (1975).

    Article  Google Scholar 

  7. Border, W., Lehman, D., Egan, J., Sass, H., Glode, J. and Wilson, C.B.: Antitubular basement membrane antibodies in methicillin-associated interstitial nephritis. New. Engl. J. Med. 291: 381–384, (1974).

    Article  Google Scholar 

  8. Brentjens, J., O’Connell, D., Pawloski, I. and Andres, G.A.: Extraglomerular lesions associated with depoöitibn of circulating antigen-antibody complexes in kidneys of rabbits with chronic serum sickness. Clin. Immunol. Immunopath. 3: 112–122, (1974).

    Article  Google Scholar 

  9. Brentjens, J., Sepulveda, M., Baliah, T., Bentzel, C., Erlanger, B., Elwood, C., Montes, M., Hsu, K. and Andres, G.A.: Interstitial immune complex nephritis in patients with systemic lupus erythematosus- Kidney Int. 7: 342–350, (1975).

    Google Scholar 

  10. Brod, J. and Benesova, D.: A comparative study of fuctional and morphological renal changes in glomerulonephritis. Acta Med. Scand. 157: 23–32, (1957).

    Article  Google Scholar 

  11. Case records of the Massachusetts General Hospital: Case 2 – 1976. New Engl. J. Med. 294: 100–105, (1976).

    Google Scholar 

  12. Chesvey, R., O’Regon, S., Guyda, H.Y. and Drummond, K.N.: Candida endocrinopathy syndrome with membranoproliferative glomerulonephritis: demonstration of glomerular Candida antigen. Clin. Nephrol. 5: 232–238, (1976).

    Google Scholar 

  13. Cochrane, C.G.: Mechanisms involved in deposition of immune complexes in tissue. J. Exp. Med. 134: (Pt. 2): 75s-89s, (1971).

    Article  Google Scholar 

  14. Colvin, R.B., Burton, N.E., Hyslop, N. E. Jr., Spitz, L, and Lichtenstein, N.S.: Penicillin-associated interstitial nephritis. Ann. Int. Med. 81: 404–405, (1974).

    Google Scholar 

  15. Cotran, R.S. and Peissens, W.F.: Pathogenesis 03 chronic pyelonephritis. Proc. Int. Congr. Nephrol., 6th, pp. 509–523 (Karger- Basel, 1976).

    Google Scholar 

  16. Couser, W. and Salant, G.: In situ immune complex formation and glomerular injury. Kidney Int. 17: 1–14, (1980).

    Article  Google Scholar 

  17. Faarup, P. and Cristensen, E.: IgE containing plasma cells in acute tubulo-interstitial nephropathy. Lancet 2: 718, (1974).

    Article  Google Scholar 

  18. Fleuren, G., Grond, J. and Hoedemacker, P.J.: In situ formation of subepithelial glomerular immune complexes in passive serum sickness. Kidney Int. 17: 631–637, (1980).

    Article  Google Scholar 

  19. Gelfand, M.C., Frank, M.M., Green, I, and Shin, M.L.: Binding sites of immune complexes containing IgG in the renal inter- stitium. Clin. Immunol. Immunopath. 13: 19–29, (1979).

    Article  Google Scholar 

  20. Grupe, W.E.: An “in vitro” demonstration of cellular sensitivity in experimental autoimmune nephrosis in rats. Proc. Soc. Exp. Biol. Med. 127: 1217–1222, (1968).

    Google Scholar 

  21. Harner, M.H., Nolte, M., Wilson, C.B., Talwalker, Y.B., Musgrave, J.E., Brooks, R.E. and Campbell, R.A.: Anti-tubular basement membrane antibody and nephrotic syndrome associated with milk hypersensitivity. Abstr. 3rd Int. Symp. Pediat. Nephrol., Washington, p. 8 (1974).

    Google Scholar 

  22. Heptinstall, R.H.: Interstitial nephritis; a brief review. Amer. J. Pathol. 83: 214–236, (1976).

    Google Scholar 

  23. Heymann, W., Hackel, D.B., Harwood, S., Wilson, S.G.F. and Hunter, J.L.P.: Production of nephrotic syndrome in rats by Freund’s adjuvant and rat kidney suspension. Proc. Soc. Exp. Biol. Med. 100: 660–664, (1959).

    Google Scholar 

  24. Hozer, J.R.: Tubulointerstitial immune complex nephritis in rats immunized with Tamm~Horsfall protein. Kidney Int. 17: 284–292, (1980).

    Article  Google Scholar 

  25. Hyman, L.R., Ballow, M. and Knieser, M.R.: Diphenylhydantoin nephropathy: Evidence for an autoimmune pathogenesis. Kidney Int. 8: 450, (1975) (Abstr.)

    Google Scholar 

  26. Hyman, L.R., Colvin, R.B. and Steinberg, A.D.: Immunopatho- genesis of autoimmune tubulointerstitial nephritis. I. Demonstration of differential susceptibility in strain II and strain XIII guinea pigs. J. Immunol. 116: 327–335, (1976).

    Google Scholar 

  27. Hyman, L.R., Steinberg, A.D., Colvin, R.B. and Bernard, E.F.: Immunopathogenesis of autoimmune tubulointerstitial nephritis. II. Role of an immune response gene linked to the major histocompatibility locus. J. Immunol. 117: 1894–1897, (1977).

    Google Scholar 

  28. Kawowski, S., McKay, D.G.: Howes, E. L. Jr., Csavossy, I. and Wolfson, M.: Multinucleated giant cells in antiglomerular basement membrane antibody-induced glomerulonephritis. Nephron 16: 415–426, (1976).

    Article  Google Scholar 

  29. Klassen, J., Andres, G., Brennen, J. and McCluskey, R.T.: An immunologic renal tubular lesion in man. Clin. Immunol. Immunopath. 1: 69–83, (1972).

    Article  Google Scholar 

  30. Klassen, J., Kano, K., Milgrom, F., Menno, A., Anthone, R., Sepulveda, M., Elwood, C. and Andres, G.A.: Tubular lesions produced by autoantibodies to tubular basement membranes in human renal allografts. Int. Arch. All. Appl. Immunol. 45: 675–689, (1973).

    Article  Google Scholar 

  31. Klassen, J., McCluskey, R.T. and Milgrom, F.: Nonglomerular renal disease produced in rabbits by immunization with homologous kidney. Amer. J. Pathol. 63: 333–350, (1971).

    Google Scholar 

  32. Klassen, J. and Milgrom, F.: Autoimmune concomitants of renal allografts. Transplant. Proc. 1: 605–608, (1969).

    Google Scholar 

  33. Klassen, J., Sugisaki, T., Milgrom, F. and McCluskey, R.T.: Studies on multiple renal lesions in Heymann nephritis. Lab. Invest. 25: 571–585, (1971).

    Google Scholar 

  34. Lehman, D.H., Lee, S., Wilson, C.B. and Dixon, F.J.: Induction of antitubular basement membrane antibodies in rats by renal transplantation. Transplantation 17: 429–431, (1976).

    Article  Google Scholar 

  35. Lehman, D.H.; Marquardt, H., Wilson, C.B. and Dixon, F.J.: Specificity of autoantibodies to tubular and glomerular basementmembranes induced in guinea pigs. J. Immunol. 112: 241–248, (1974).

    Google Scholar 

  36. Lehman, D.H. and Wilson, C.B.: Role of sensitized cells in antitubular basement membrane interstitial nephritis. Int. Arch. All. Appl. Immunol. 51: 168–176, (1976).

    Article  Google Scholar 

  37. Lehman, D.H., Wilson, C.B. and Dixon, F.J.: Interstitial nephritis in rats immunized with heterologous tubular basement membrane. Kidney Int. 5: 187–195, (1974).

    Article  Google Scholar 

  38. Lehman, D.H., Wilson, C.B. and Dixon, F.J.: Extraglomerular immunoglobulin deposits in human nephritis. Amer. J. Med. 58: 765:786, (1975).

    Article  Google Scholar 

  39. Levy, M., Gagnadoux, M.F., Beziall, A. and Habib, R.: Membranous glomerulonephritis associated with antitubular and antialveolar basement membrane antibodies. Clin. Nephrol. 10: 158–165, (1978).

    Google Scholar 

  40. Levy, M., Gagnadoux, M.F. and Habib, R.: An immunologic Fanconi syndrome. Int. Symp. Pediat. Nephrol., 3rd, Washington, D.C. (1974).

    Google Scholar 

  41. Lewis, E.J., Cavallo, J.A., Harrington, J.T. and Cotran, R.S.: An immunopathologic study on rapidly progressive glomerulonephritis in the adult. Human Pathol. 2: 185–208, (1971).

    Article  Google Scholar 

  42. Letwin, A., Adams, L.E., Levy, R., Cline, S. and Hess, E.B.: Cellular immunity in experimental glomerulonephritis of rats: I. Delayed hypersensitivity and lymphocyte stimulation studies with renal tubular antigen. Immunology 20: 755–766, (1971).

    Google Scholar 

  43. McCluskey, R.T. and Klassen, J.: Immunologically mediated glomerular tubular and interstitial renal disease. New. Engl. J. Med. 288: 564–570, (1973).

    Article  Google Scholar 

  44. McLeish, K. Senitzer, D. and Gohara, A.: Acute interstitial nephritis in a patient with aspirin hypersensitivity. Clin. Immunol. Immunopath. 14: 64–69, (1979).

    Article  Google Scholar 

  45. McPhaul, J.J. and Dixon, F.J.: Characterization of human anti- glomerular basement membrane antibodies eluated from glomerulo- nephritic kidneys. Clin. Invest. 49: 308–317, (1970).

    Article  Google Scholar 

  46. Morel-Maroger, L., Kourilsky, O. Mignon, F. and Richet, G.: Antitubular basement membrane antibodies in rapidly progressive poststreptococcal glomerulonephritis. Clin. Immunol. Immunopath. 2: 185–194, (1974).

    Article  Google Scholar 

  47. Muehrcke, C., Kark, R.M., Pirani, C.L. and Pollak, V.E.: Lupus nephritis, a clinical and pathologic study based on renal biopsies. Medicine (Baltimore) 36: 1–145, (1957).

    Google Scholar 

  48. Naruse, F., Kitamura, K., Miyakawa, Y. and Shibata, S.: Depo- sition of renal tubular antigen along the glomerular capillary walls of patients with membranous glomerulonephritis. J. Immunol. 110: 1163–1166, (1973).

    Google Scholar 

  49. Nicastri, A.D., Chen, C.K., Rao, T.K.S., Ginzler, E.M., Kaplan, D. and Friedman, E.A.: Renal disease with tubular immunofluorescence deposits. Kidney Int. 8: 452, (1975) (Abstr:).

    Google Scholar 

  50. Noble, B., Mendrick, D., Brentjens, J.R. and Andres, G.A.: Damage of renal proximal tubules by passive transfer of homologous brush border antibodies. Fed. Proc. 39, I: 815A, (1980).

    Google Scholar 

  51. Olsen, S. and Asklund, M.: Interstitial nephritis with acute renal failure following cardiac surgery and treatment with methicillin. Acta Med. Scand. 99: 305–310, (1976).

    Google Scholar 

  52. Ooi, B.S., First, M.R., Pesce, A.J., Pollak, V.E., Bernstein, I.L. and lag, W.: IgE levels in interstitial nephritis. Lancet 1: 1254–1256, (1974).

    Article  Google Scholar 

  53. Ozawa, T., Boedecker, E.A., Scharr, W., Guggenheim, S. and Mcintosh, R.M.: Immune-complex disease with unilateral renal vein thrombosis. Arch. Path. 100: 279–282, (1976).

    Google Scholar 

  54. Paul, L., Van Es, L., Stuffers-Heiman, M., Brutel,. Riviere, G. and Kalff, M. Antibodies directed against tubular basement membranes in human renal allograft recipients. Clin. Immunol. Immunopath. 14: 231–237, (1979).

    Article  Google Scholar 

  55. Proskey, A.J., Weatherbee, L., Esterling, R.E., Greene, J.A. and Weiler, J.M.: Goodpasture’s syndrome. A report of five cases and review of the literature. Amer. J. Med. 48: 162–173, (1970).

    Article  Google Scholar 

  56. Risdon, R.A., Sloper, J.C. and de Wardener, H.E.: Relationship between renal function and histological changes found in renal biopsy specimens from patients with persistent glomerular nephritis. Lancet. 2: 263–266, (1968).

    Google Scholar 

  57. Rudofsky, U.H., McMaster, P.R.B., Ma, W., Steblay, R.W. and Pollara, B.: Experimental autoimmune renal cortical tubulo- interstitial disease in guin a pigs lacking the fourth component of complement (C4). J. Immunol. 112: 1387–1393, (1974).

    Google Scholar 

  58. Rudofsky, U.H., Steblay, R.W. and Pollara, B.: Inhibition of experimental autoimmune renal tubulointerstitial disease in guinea pigs by depletion of complement with cobra venom factor. Clin. Immunol. Immunopath. 3: 396–402, (1975).

    Article  Google Scholar 

  59. Shwayder, M., Ozawa, T., Boedecker, E., Guggenheim, S. and Mcintosh, R.H.: Nephrotic syndrome associated with Fanconi syndrome. Immunopathogenic studies of tubulointerstitial nephritis with autologous immune-complex glomerulonephritis. Ann. Intern. Med. 84: 432–437, (1976).

    Google Scholar 

  60. Sloper, J.C., de Wardener, H. and Woodrow, D.F.: Relationship between renal structure and function deduced from renal biopsies. In: Renal Pathophysiology. Leaf, A, Giebisch, G., Bolis, L. and Gorini, S. eds. pp. 109–120 (Raven Press, New York, 1980).

    Google Scholar 

  61. Steblay, R.W. and Rudofsky, U.H.: Transfer of experimental autoimmune renal cortical tubular and interstitial disease in guinea pigs by serum. Science 180: 966–968, (1973).

    Article  ADS  Google Scholar 

  62. Steblay, R.W. and Rudofsky, U.H.: Renal tubular disease and autoantibodies against tubular basement membrane induced in guinea pigs. J. Immunol. 107: 589–594, (1971).

    Google Scholar 

  63. Strauss, J., Pardo, V., Koss, M.N., Griswold, W. and Mcintosh, M.: Nephropathy associated with sickle cell anemia: An autologous immune complex nephritis. Amer. J. Med. 58: 382–387, (1975).

    Article  Google Scholar 

  64. Sugisaki, T., Klassen, J., Andres, G.A., Milgrom, F. and McCluskey, R.T.: Species specific renal lesions in different rat strains. VI Intern. Cong. Nephrol. (Abstr.), Firenze, Italy, p. 304, (1975).

    Google Scholar 

  65. Sugisaki, T., Klassen, J., Milgrom, G., Andres, G.A. and McCluskey, R.T.: Immunopathologic study of an autoimmune tubular and interstitial renal disease in Brown Norway rats. Lab. Invest. 28: 658–671, (1973).

    Google Scholar 

  66. Sugisaki, T., Yoshida, T., McCluskey, R.T., Andres, G.A. and Klassen, J.: Autoimmune cell-mediated tubulointerstitial nephritis induced in Lewis rats by renal antigens. Clin. Immunol, Immunopath. 15: 33–43, (1980).

    Article  Google Scholar 

  67. Sutton, J. and Weiss, L.: Transformation of monocytes in tissue culture into macrophages, epithelial cells and multinucleated giant cells. An electron microscopic study. J. Cell. Biol. 28: 303–332, (1966).

    Article  Google Scholar 

  68. Tung, K. and Black, W.: Association of renal glomerular and tubular immune complex disease and antitubular basement membrane antibody. Lab. Invest. 32: 696–700, (1975).

    Google Scholar 

  69. Van Zwieten, M.J., Bhan, A.K., McCluskey, R.T. and Collins, A.B.: Studies on the pathogenesis of experimental anti-tubular basement membrane nephritis in the guinea pig. Amer. J. Pathol. 83: 531–546, (1976).

    Google Scholar 

  70. Van Zwieten, M.J., Leber, P.D., Bhan, A.K, and McCluskey, R.T.: Experimental cell mediated interstitial nephritis induced with exogenous antigens. J. Immunol. 118: 589–593, (1977).

    Google Scholar 

  71. Wilson, C.B. and Dixon, F.L.: Antiglomerular basement membrane antibody-induced glomerulonephritis. Kidney Int. 3: 74–89, (1973).

    Article  Google Scholar 

  72. Wilson, C.B., Lehman, D., McCoy, R., Gunnels, J. and Stubel, D.: Antitubular basement membrane antibodies after renal transplantation. Transplantation, 18: 447–452, (1974).

    Article  Google Scholar 

  73. Wilson, C.B. and Dixon, F.J.: Diagnosis of immunopathologic renal disease. Editorial, Kidney Int. 5: 389–401, (1974).

    Article  Google Scholar 

  74. Wilson, C.B. and Dixon, F.J.: The renal response to immunological injury. In: The Kidney. Brenner, B.M. and Rector, F.C. Jr., eds. Vol. II, pp. 838–940 (W.B. Saunders Co., Philadelphia, 1976).

    Google Scholar 

  75. Wilson, C.B. and Dixon, F.J.: Renal injury from immune reactions involving antigens in or of the kidney. In: Immunologic Mechanisms of Renal Disease. Wilson, C.B., Brenner, B.M. and Stein, J.H., eds., pp. 35–66 (Churchill Livingstone, New York, 1979).

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Microbiology, Pathology and Medicine, State University of New York at Buffalo, Buffalo, New York, 14214, USA

    T. Sugisaki & G. Andres

Authors
  1. T. Sugisaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Andres
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University Polyclinic Hospital, Palermo, Italy

    Michele Pavone-Macaluso

  2. St. James’s University Hospital, Leeds, England

    Philip H. Smith

  3. University of Turin, Turin, Italy

    Antonio Vercellone

  4. United Hospitals, Brescia, Italy

    Rosario Maiorca

  5. University Polyclinic Hospital, Palermo, Italy

    Ugo Rotolo

Rights and permissions

Reprints and permissions

Copyright information

© 1981 Plenum Press, New York

About this chapter

Cite this chapter

Sugisaki, T., Andres, G. (1981). Immunopathology of Tubulo-Interstitial Nephritis in Man and in Experimental Animals. In: Pavone-Macaluso, M., Smith, P.H., Vercellone, A., Maiorca, R., Rotolo, U. (eds) Advances in Nephrourology. Ettore Majorana International Science Series, vol 9. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-8944-6_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4684-8944-6_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-8946-0

  • Online ISBN: 978-1-4684-8944-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation