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Mechanisms of Glomerular Disease

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Glomerulonephritis

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Abstract

Glomerular diseases, clinically manifesting with proteinuria, hematuria, or azotemia, result from complex disease processes. This complexity is driven by an individual’s genome, unique environmental exposures, and, importantly, through their interaction mediated by innate and adaptive immune responses. The astonishing complexity of each of these aspects is emerging through the lens of new technologies that provide the ability to interrogate human biosamples, including kidney biopsies, in exquisite molecular detail. An individual’s genetic background, their immune responses, and environmental exposures interactively contribute to disease pathogenesis to shape complex disease phenotypes such as glomerulonephritis. In this chapter we review the general pathogenic mechanisms that drive multiple glomerular disease diagnoses and have selected a few specific examples to illustrate how these pathogenic mechanisms influence disease initiation or progression. We have divided the disease mechanisms into the general domains of genetics and innate and adaptive immunity and highlight how genetic background modifies the immune response to cause glomerular diseases in susceptible individuals.

The authors have no conflicts to declare related to this manuscript.

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Authors and Affiliations

  1. Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA

    John F. O’Toole & John R. Sedor

  2. Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

    John F. O’Toole & John R. Sedor

  3. Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC, USA

    Dhruti P. Chen

Authors
  1. John F. O’Toole
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  2. Dhruti P. Chen
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  3. John R. Sedor
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Corresponding author

Correspondence to John F. O’Toole .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, NYU Langone Medical Center, New York, NY, USA

    Howard Trachtman

  2. Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA

    Leal C. Herlitz

  3. Nephrology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA

    Edgar V. Lerma

  4. Renal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Jonathan J. Hogan

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O’Toole, J.F., Chen, D.P., Sedor, J.R. (2019). Mechanisms of Glomerular Disease. In: Trachtman, H., Herlitz, L., Lerma, E., Hogan, J. (eds) Glomerulonephritis. Springer, Cham. https://doi.org/10.1007/978-3-319-49379-4_2

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  • DOI: https://doi.org/10.1007/978-3-319-49379-4_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49378-7

  • Online ISBN: 978-3-319-49379-4

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