A Personal Perspective on the State of the Art in Research in Glomerulonephritis
During the 20 years in which I have been personally involved in research on glomerulonephritis, the field has undergone a remarkable transformation. From the initial probing excursions into the pathogenesis of glomerulonephritis in the early 1960s a highly sophisticated discipline has arisen. Wide application of electron microscopic and immunofluorescent techniques to human biopsy material has taught us much, focused our interest on aberrant immune processes, and brought an ever-increasing complexity to the classification of human glomerular diseases. Paradigms developed during this period have, after a time of widespread acceptance, recently shown unmistakable signs of being replaced by a new and more richly varied set of dogmas. To the clinician, not directly involved in research in this area, the field seems to be ever more populated with an often bewildering variety of spontaneous and induced models of glomerular disease in experimental animals. However, experimental approaches in animals have been the bedrock of investigation into the pathogenesis of glomerulonephritis, and this work has taught us much about the ways in which aberrant immune processes bring about glomerular injury and the factors that mediate the injury itself. Highly sophisticated procedures such as direct micropuncture of glomerular capillaries and even isolated perfusion of individual glomeruli, tissue culture and cell cloning of glomerular constituents, receptor binding and enzyme kinetics, and very recently the development of monoclonal antibodies as probes of glomerular structure promise to add exciting new dimensions to our understanding of a structure that less than a decade ago was viewed as only a passive ultrafilter serving primarily to provide a rich supply of water and ions to the tubules for reabsorption.
KeywordsGlomerular Disease Glomerular Injury Induce Model Glomerular Capillary Wall Immune Complex Disease
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