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本文介绍有关肾小管间质性疾病(TIN)免疫发病机理的新进展。 1、急性过敏反应引起的间质性肾炎由IgE介导的肾脏损害不常见,但对于某些急性间质性肾炎,特别是那些由药物引起的间质性肾炎却十分重要。临床上常表现为发热、皮疹、嗜伊红细胞增多及肾功能下降。这些表现一般出现在初次用药后2～37天。血清IgE水平往往增高,Prausnitz-Kustner反应可以阳性,肾间质水肿伴大量炎性细胞浸润主要为嗜酸细胞,这种损伤机制可能是药物或其它试剂作为抗原或半抗原与IgE抗体在肥大细胞和嗜硷性细胞表面互相反应引起的细胞膜结构改变,释放炎症介质,包括组织胺,5-羟色胺,缓激肽、过敏性慢反应物质(SRS-A)及嗜酸细胞趋化因子等。 2、抗肾抗体引起的间质性肾炎
This article describes new advances in the pathogenesis of tubulointerstitial disease (TIN) immunity. 1, interstitial nephritis caused by acute allergic reactions IgE-mediated renal damage is not common, but for some acute interstitial nephritis, especially those caused by drug-induced interstitial nephritis is very important. Clinical manifestations of fever, rash, eosinophilia and decreased renal function. These manifestations generally appear after 2 to 37 days after initial administration. Serum IgE levels tend to increase, Prausnitz-Kustner reaction can be positive, interstitial edema with a large number of inflammatory cell infiltration mainly eosinophils, this damage mechanism may be drugs or other reagents as antigens or haptens and IgE antibodies in mast cells And basophilic cell surface caused by mutual reaction of the cell membrane structure changes, the release of inflammatory mediators, including histamine, serotonin, bradykinin, allergic slow response substances (SRS-A) and eotaxin and so on. 2, anti-renal antibodies caused by interstitial nephritis