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      Pathogenesis of poststreptococcal glomerulonephritis a century after Clemens von Pirquet.

      Kidney International

      pathogenicity, chemistry, Streptococcus pyogenes, pathology, immunology, complications, Streptococcal Infections, Scarlet Fever, Molecular Mimicry, Models, Immunological, metabolism, Kidney Glomerulus, Humans, Glyceraldehyde-3-Phosphate Dehydrogenases, microbiology, etiology, Glomerulonephritis, Fibrinolysin, Exotoxins, Bacterial Proteins, Animals

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          Abstract

          Considerable insight has been gained into the etiopathogenesis of poststreptococcal glomerulonephritis since the landmark theoretical construct of Clemens von Pirquet postulated that disease-causing immune complexes were responsible for the nephritis that followed scarlet fever. Over the years, molecular mimicry between streptococcal products and renal components, autoimmune reactivity and several streptococcal antigens have been extensively studied. Recent investigations assign a critical role to both in situ formation and deposition of circulating immune complexes that would trigger a variety of effector mechanisms. Glomerular plasmin-binding activity of streptococcal glyceraldehyde-3-phosphate-dehydrogenase may play a role in nephritogenicity and streptococcal pyrogenic exotoxin B and its zymogen precursor may be the long-sought nephritogenic antigen.

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          Journal
          10.1038/sj.ki.5002169
          17342179

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