Although it has been appreciated for many years that immune processes
underlie most types of glomerulonephritis, it is the recent explosion in
knowl- edge of cellular and molecular immunology that has prompted
another book on the subject. The understanding of the mechanisms
involved in renal injury requires the integration of information from in
vitro cell-culture systems, experimental models of disease, and clinical
studies. This volume draws on all of these sources in an attempt to
explain current concepts of nephritis. Increased emphasis is placed on
autoimmune processes, as opposed to the deposition of circulating immune
complexes, although it will be apparent that these may overlap in the
area of "in situ" immune complex formation. Of central importance in
autoimmunity is the relationship between antigen pre- senting cells
(including B cells) expressing MHC class II molecules, autoan- tigenic
peptides, T helper lymphocytes, and various effector cells. The
mechanisms by which the immune system may lead to tissue injury are also
becoming better understood, and consideration is given to the role of
inflam- matory cells, the complement proteins, and soluble factors such
as cytokines and eicosanoids.