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Immunologic Mechanisms in Drug-Induced Acute Interstitial Nephritis

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Nephrotoxic Mechanisms of Drugs and Environmental Toxins

Abstract

It is well established that certain therapeutic agents can cause acute interstitial nephritis (AIN),* which is characterized histologically by interstitial edema, leukocytic infiltration, and tubular cell damage (Baldwin et al., 1968; McCluskey and Colvin, 1978). The infiltrate usually consists principally of mononuclear cells, most of which have the appearance of lymphocytes, but eosinophils are usually present, often in large numbers, and plasma cells, as well as small numbers of basophils, are frequently found. Tubules are often invaded by leukocytes and severe tubular damage may be seen. The glomeruli and blood vessels appear normal. In most cases there are no characteristic immunofluorescence findings and distinctive ultrastructural features are not seen.

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References

  • Andres, G. A., and McCluskey, R. T., 1975, Tubular and interstitial renal disease due to immunologic mechanisms, Kidney Int. 7:271.

    Article  CAS  Google Scholar 

  • Baldwin, D. S., Levine, B. B., McCluskey, R. T., and Gallo, G. R., 1968, Renal failure and interstitial nephritis due to penicillin and methicillin, N. Engl. J. Med. 279:1245.

    Article  CAS  Google Scholar 

  • Bhan, A. K., Reinherz, E. L., Poppema, S., McCluskey, R. T., and Schlossman, S. F., 1980, Location of T cell and major histocompatibility complex antigens in the human thymus, J. Exp. Med. 152:771.

    Article  CAS  Google Scholar 

  • Bhan, A. K., Nadler, L. M., Skashenko, P., McCluskey, R. T., and Schlossman, S. F., 1981, Stages of B cell differentiation in human lymphoid tissue, J. Exp. Med. 154:737.

    Article  CAS  Google Scholar 

  • Bhan, A. K., Colvin, R. B., Cosimi, A. B., and McCluskey, R. T., 1982, Nature of cellular infiltrate in renal allograft rejection. Kidney Int. 21:293 (abstract).

    Google Scholar 

  • Border, W. A., Lehman, D. H., Egan, J. D., Sass, H. J., Glade, J. E., and Wilson, C. B., 1974, Anti-tubular basement membrane antibodies in methicillin associated interstitial nephritis, N. Engl. J.Med. 291:381.

    Article  CAS  Google Scholar 

  • Brentjens, J. R., O’Donnell, D. W., Pawlowski, I. B.,and Andres, G. A., 1974, Extra-glomerular lesions associated with deposition of circulating antigen-antibody complexes in kidneys of rabbits with chronic serum sickness, Clin. Immunol. Immunopathol. 3:112.

    Article  CAS  Google Scholar 

  • Cantor, H., 1979, Control of the immune system by inhibitor and inducer T lymphocytes, Ann. Rev.Med. 30:269.

    Article  CAS  Google Scholar 

  • Colvin, R. B., and Dvorak, H. F., 1979, Role of granulocytes in cell-mediated immunity, in: Mechanisms of Immunopathology (S. Cohen, P. A. Ward, and R. T. McCluskey, eds.), Wiley, New York, p. 69.

    Google Scholar 

  • Colvin, R. B., Burton, N. E., and Hyslop, N. E., 1974, Penicillin associated interstitial nephritis, Ann.Intern. Med. 81:404.

    CAS  Google Scholar 

  • Councilman W. T., 1898, Acute interstitial nephritis, J. Exp. Med. 3:393.

    Article  CAS  Google Scholar 

  • Domoto, D. T., Askenase, P. W., and Kashgarian, M., 1977, Tubulointerstitial nephritis (TIN) due to fluorescein isothiocyanate (FITC). A possible hapten-immunologically mediated reaction, KidneyInt. 12:512 (abstract).

    Google Scholar 

  • Faarup, P., and Christensen, E., 1974, IgE containing plasma cells in acute tubulointerstitial nephropathy, Lancet 2:718.

    Article  CAS  Google Scholar 

  • Galpin, J. E., Shinaberger, J. H., Stanley, T. M., Blumenbrantz, M. J., Bayer, A. S., Friedman, G. S., Montgomerie, J. Z., Guzr, L. B., Coburn, J. W., and Glassock, R. J., 1978, Acute interstitial nephritis due to methicillin, Am. J. Med. 65:756.

    Article  CAS  Google Scholar 

  • Husby, G., Tung, K. S. K., and Williams, R. C., 1981, Characterization of renal tissue lymphocytes in patients with interstitial nephritis, Am. J. Med. 70:31.

    Article  CAS  Google Scholar 

  • Jaffe, E. S., and Green, I., 1977, Neoplasms of the immune system in: Mechanisms of Tumor Immunity (I. S. Green, S. Cohen, and R. T. McCluskey, eds.), Wiley, New York, p. 251.

    Google Scholar 

  • Kimmelstiel, P., 1938, Acute hematogenous interstitial nephritis, Am. J. Pathol. 14:737.

    CAS  Google Scholar 

  • Klassen, J., McCluskey, R. T., and Milgrom, F., 1971, Nonglomerular renal disease produced in rabbits by immunization with homologous kidney, Am. J. Pathol. 63:333.

    CAS  Google Scholar 

  • McCluskey, R. T., and Bhan, A. K., 1977, Cell-mediated reactions in vivo, in: Mechanisms of TumorImmunity (I. S. Green, S. Cohen, and R. T. McCluskey, eds.), Wiley, New York, p. 1.

    Google Scholar 

  • McCluskey, R. T., and Colvin, R. B., 1978, Immunological aspects of renal tubular and interstitial diseases, Ann. Rev. Med. 29:191.

    Article  CAS  Google Scholar 

  • McCluskey, R. T., Bhan, A. K., and Colvin, R. B 1982, Experimental and human anti-tubular basement membrane (TBM) nephritis, in NIHSymposium, in press.

    Google Scholar 

  • Mery, J. P., and Morel-Maroger, L., 1976, Acute interstitial nephritis: A hypersensitivity reaction to drugs, in: Proceedings of the 6th International Congress of Nephrology (S. Giovannetti, V. Bonomini, and G. D’Amico, eds.), Basel, p. 524.

    Google Scholar 

  • Olsen, S., and Asklund, M., 1976, Interstitial nephritis with acute renal failure following cardiac surgery and treatment with methicillin, Acta Med. Scand. 199:305.

    Article  CAS  Google Scholar 

  • Ooi, B. S., 1975, Acute interstitial nephritis. A clinical and pathologic study based on renal biopsies, Am. J. Med. 59:614.

    Article  CAS  Google Scholar 

  • Parker, C. W., 1980, Drug allergy, in: Clinical Immunology, Volume II (C. W. Parker, ed.), Saunders, Philadelphia, Pennsylvania, p. 1219.

    Google Scholar 

  • Phillips, S. M., and Neilson, E. G., 1981, Antibody-dependent cellular cytotoxicity (ADCC): A new effector mechanism in interstitial nephritis, Kidney Int. 19:189 (abstract).

    Google Scholar 

  • Poppema, S., Bhan, A. K., Reinherz, E. L., McCluskey, R. T., and Schlossman, S. F., 1981, Distribution of T cell subsets in human lymph nodes, J. Exp. Med. 153:30.

    Article  CAS  Google Scholar 

  • Reinherz, E. L.,and Schlossman, S. F., 1980, The differentiation and function of human T lymphocytes, Cell 19:821.

    Article  CAS  Google Scholar 

  • Stashenko, P., Nadler, R., Hardy, S., and Schlossman, S. F., 1980, Characterization of a human B lymphocyte-specific antigen, J. Immunol. 125:1678.

    CAS  Google Scholar 

  • Steblay, R. W., and Rudofsky, U. H., 1971, Renal tubular disease and autoantibodies against tubular basement induced in guinea pigs, J. Immunol. 107:589.

    CAS  Google Scholar 

  • Sugisaki, T., Yoshida, T., McCluskey, R. T., Andres, G. A., and Klassen, J., 1980, Autoimmune cell-mediated tubulointerstitial nephritis induced in Lewis rats by renal antigens, Clin. Immunol. Immunopathol. 15:33.

    Article  CAS  Google Scholar 

  • Van Zwieten, M. J., Leber, P. D., Bhan, A. K.,and McCluskey, R. T., 1977, Experimental cell-mediated interstitial nephritis induced with exogenous antigens, J. Immunol. 118:589.

    Google Scholar 

  • Weiler, P. F., and Goetzl, E. J., 1979, The regulatory and effector roles of eosinophils, in: Advances in Immunology, Volume 27 (H. G. Kunkel and F. J. Dixon, eds.), Academic Press, New York, p. 339.

    Google Scholar 

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McCluskey, R.T., Bhan, A.K. (1982). Immunologic Mechanisms in Drug-Induced Acute Interstitial Nephritis. In: Porter, G.A. (eds) Nephrotoxic Mechanisms of Drugs and Environmental Toxins. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-4214-4_34

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  • DOI: https://doi.org/10.1007/978-1-4684-4214-4_34

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-4216-8

  • Online ISBN: 978-1-4684-4214-4

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