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Nephrology pp 151-163 | Cite as

The Pathogenesis of Tubulointerstitial Nephritis

  • Peter S. Heeger
  • Gunter Wolf
  • Eric G. Neilson

Summary

Tubulointerstitial nephritis is a common form of both acute and chronic renal disease in humans. Over the last 12 years we have been studying the pathogenic mechanisms involved in tubulointerstitial nephritis, using several animal models which are similar to distinct forms of human interstitial injury. The immunopathogenesis of tubulointerstitial nephritis can be arbitrarily divided into three phases. The afferent, or antigen recognition phase, involves expression of the nephritogenic antigen, recognition and presentation of the nephritogenic antigen in the context of appropriate MHC determinants, and circumvention of the usual mechanisms of tolerance. The immunoregulatory phase consists of multiple counter-regulatory events, both humoral and cell-mediated, that influence the amplitude and qualitative nature of the immune response. The final, effector, phase includes the various mechanisms directly responsible for tubulointerstitial injury and subsequent fibrosis. Additionally, once the immune response has been initiated, a number of factors can influence the progression of tubulointerstitial injury toward end stage renal disease.

Keywords

Interstitial Nephritis Tubular Epithelium Tubulointerstitial Nephritis Immune Deposit Tubulointerstitial Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Peter S. Heeger
  • Gunter Wolf
  • Eric G. Neilson
    • 1
  1. 1.Renal-Electrolyte Section of the Department of Medicine, and the Cell Biology and Immunology Graduate GroupsUniversity of PennsylvaniaPhiladelphiaUSA

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