How is mechanism of glomerular injury and disease?

➢ Immune mechanisms underlie most types of primary glomerular diseases and many of the secondary glomerular diseases. ➢ Two mechanisms of antibody deposition in the glomerulus have been established: (1) Deposition of circulating antigen-antibody complexes in the glomerular capillary wall or mesangium (2) Antibodies reacting in situ within the glomerulus, either with fixed (intrinsic) glomerular antigens or with extrinsic molecules that are planted in the glomerulus. ➢These pathways are not mutually exclusive, and in humans all may contribute to injury. ➢Abnormal activation and glomerular deposition of complement may be the only pathologic mecanism in some forms of GN. ➢Cell-mediated immune mechanisms also may play a role in certain glomerular diseases