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Immune complexes and complexity: investigating mechanisms of renal disease.
International Urology and Nephrology 2017 April
The deposition of immune complexes is the causal factor in distinct renal pathologies, e.g., lupus nephritis and membranous nephritis. The location of these deposits within a tissue biopsy is often the key to establishing a diagnosis. However, how immune complexes come to be deposited below the vascular endothelium was, until now, a mystery, as was their contribution to inducing inflammation. A recent paper in Cell by Stamatiades et al. (Cell 164(4):991-1003, 2016) demonstrates the active transport of immune complexes by the vascular endothelial cells and an Fc receptor-dependent uptake by tissue-resident macrophages. This leads to the activation of these macrophages and the release of pro-inflammatory cytokines, which in turn recruits immune cells from the blood into the kidney. The identification of these mechanisms should lead to a better stratification of kidney diseases and hopefully to the development of specific therapies.
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