Objective 20: Explain Immune Mechanism Associated to Glomerular Disease

Immune-Mediated Glomerular Disease

Glomerular injury caused by an abnormal immune response that damages the filtration barrier.

Antigen

Foreign substance that triggers an immune response.

Antibody

Protein produced by the immune system that binds to a specific antigen.

Antigen-Antibody Complex

Structure formed when an antibody binds to its matching antigen.

Immune Complex Deposition

Accumulation or association of antigen-antibody complexes with glomerular structures.

Complement System

Immune system pathway that can be activated by immune complexes and promote inflammation.

Complement Activation in Glomeruli

Triggers inflammatory responses and attracts inflammatory cells that contribute to tissue injury.

Glomerular Permeability

Ability of the filtration barrier to allow substances to pass from blood into filtrate.

Increased Glomerular Permeability

Allows red blood cells and proteins to leak into the urine.

Hematuria from Glomerular Injury

Red blood cells enter urine through a damaged glomerular filtration barrier.

Proteinuria from Glomerular Injury

Protein leaks into urine because the filtration barrier is damaged.

Decreased GFR from Glomerular Inflammation

Inflammatory swelling and cellular proliferation reduce effective filtration.

Nephritic Pattern

Immune-related glomerular injury dominated by inflammation, causing hematuria and reduced GFR.

Nephrotic Pattern

Glomerular injury dominated by increased permeability and extensive protein loss.

Hypoalbuminemia

Low blood albumin caused by excessive urinary protein loss.

How can the immune system cause glomerular disease?

An abnormal immune response can damage the glomerular filtration barrier.

What happens when the body encounters a foreign antigen?

The immune system may produce antibodies that bind to the antigen.

What is an antigen-antibody complex?

A structure formed when an antibody binds to its matching antigen.

What can happen when immune complexes become associated with glomeruli?

They can activate complement and trigger inflammation.

What is the role of complement activation in glomerular disease?

It promotes inflammation and attracts inflammatory cells that contribute to tissue injury.

How does immune inflammation affect glomerular permeability?

It damages the filtration barrier and allows blood cells and proteins to enter urine.

Why does hematuria occur in immune-mediated glomerular disease?

Red blood cells pass through the damaged glomerular filtration barrier.

Why does proteinuria occur in immune-mediated glomerular disease?

Proteins leak through the damaged filtration barrier into the urine.

How does glomerular inflammation affect GFR?

Swelling and cellular proliferation interfere with filtration and decrease GFR.

What clinical pattern occurs when glomerular inflammation predominates?

Nephritic syndrome.

What findings are associated with nephritic syndrome?

Hematuria, decreased GFR, oliguria, hypertension, and edema.

What clinical pattern occurs when increased permeability and protein loss predominate?

Nephrotic syndrome.

What findings are associated with nephrotic syndrome?

Massive proteinuria, hypoalbuminemia, generalized edema, and hyperlipidemia.

What is the main difference between nephritic and nephrotic immune injury?

Nephritic injury is dominated by inflammation; nephrotic injury is dominated by excessive protein leakage.