By the end of the week, students will be able to:
Mechanisms of Immunologic Glomerular Injury
- Examine the basic Mechanisms of Immunologic Glomerular Injury:
a. Anti-Glomerular basement membrane disease
i. Autoimmune features
ii. Mediators of injury
b. Anti-epithelial cell disease
i. Heymann nephritis as a model for human membranous glomerulonephritis
ii. Autoimmune features
iii. Mediators of injury
iv. Review the role of phospholipase A2 receptor antibody in the pathogenesis of Membranous Nephropathy
c. Immune complex-induced disease
i. Deposition of immune complexes from the circulation
a) Properties of immune complexes
b) Sites of deposition and consequences
c) Mediators of injury
ii. In-situ immune complex formation
a) Membranous glomerulonephritis
b) Autoimmune features involved in perpetuation of glomerular injuries
c) Circulating antibody binding to planted or entrapped antigens
d. Auto-antibodies capable of activating leukocytes
i. Anti-neutrophil cytoplasmic antibodies
ii. Mechanisms of injury
Mediators of Glomerular Injury
- Discuss cellular mediators including:
a. Inflammatory cells: Neutrophils, Monocytes
b. Molecular mediators
i. Complement components
ii. Cytokines: IL-1, IL-6, TNF-alpha
iii. Reactive Oxygen Species
iv. Growth factors: PDGF, FGF, TGF-beta
Glomerular Responses to Injury
- Analyze the glomerular responses to injury including:
a. Inflammatory exudate
b. Intrinsic cell proliferation
c. Crescent formation
d. Non-inflammatory lesions
Nephrotic Syndrome
- Review the definition and clinical presentation of nephrotic syndrome
- Analyze the alterations in glomerular filtration barrier leading to proteinuria
- Discuss the mechanisms causing sodium retention
a. Primary renal sodium retention
b. Starling forces
- Examine the mechanisms underlying hypoalbuminemia
- Discuss the complications of Nephrotic syndrome
a. Hyperlipidemia
b. Hypercoagulable state
