Glomerular diseases and transplantation: similarities in pathogenetic mechanisms and treatment options

Glomerular diseases and renal transplantation have always been considered as independent fields of nephrology, due to the supposed prevalent role of antibody production and immune complex formation in glomerulonephritis versus a direct reaction of immune cell towards the grafted kidney. However, both conditions share common pathogenetical pathways, and possible new therapeutic approaches are being envisaged. Innate immunity, particularly Toll-like receptors, dendritic cells and complement pathways, B cells and antibody networks are involved in the development of glomerular damage as well as graft injury. Consequently, new treatments targeting previously not considered immune pathways, like nuclear factor-κB or the proteasome and B-cell activation with antibody production, are being tested in glomerular diseases and in transplanted kidneys.