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Journal of Immunology Research - Volume 2015 2015, Article ID 858027, 13 pages -

Review ArticleDepartment of Internal Medicine IV Nephrology and Hypertension, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria

Received 18 September 2014; Revised 26 January 2015; Accepted 3 February 2015

Academic Editor: Aurelia Rughetti

Copyright © 2015 Andreas Kronbichler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A better understanding of the pathophysiology of autoimmune disorders is desired to allow tailored interventions. Despite increased scientific interest a direct pathogenic factor in autoimmune renal disease has been described only in a minority like membranous nephropathy or ANCA-associated vasculitis. Nonetheless the initial step leading to the formation of these antibodies is still obscure. In this review we will focus on the possible role of microbial factors in this context. Staphylococcus aureus may be a direct pathogenetic factor in granulomatosis with polyangiitis GPA. Chronic bacterial colonization or chronic infections of the upper respiratory tract have been proposed as trigger of IgA vasculitis and IgA nephropathy. Interventions to remove major lymphoid organs, such as tonsillectomy, have shown conflicting results but may be an option in IgA vasculitis. Interestingly no clear clinical benefit despite similar local colonization with bacterial strains has been detected in patients with IgA nephropathy. In systemic lupus erythematosus injection of bacterial lipopolysaccharide induced progressive lupus nephritis in mouse models. The aim of this review is to discuss and summarize the knowledge of microbial antigens in autoimmune renal disease. Novel methods may provide insight into the involvement of microbial antigens in the onset, progression, and prognosis of autoimmune kidney disorders.





Autor: Andreas Kronbichler, Julia Kerschbaum, and Gert Mayer

Fuente: https://www.hindawi.com/



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