Glomerulonephritiden – Genetische Aspekte

Glomerulonephritiden zählen zu den häufigsten Ursachen für das Auftreten einer terminalen Niereninsuffizienz in der westlichen Welt. In den letzten Jahren konnten große Fortschritte im Verständnis der Ätiologie und Pathogenese dieser heterogenen, immunvermittelten Gruppe von Erkrankungen erzielt werden. Einem signifikanten Teil dieser Erkenntnisgewinne liegen genetische Untersuchungen zugrunde. Dieser Artikel fasst die wichtigsten genetischen Aspekte der IgA-Nephropathie, der membranösen Nephropathie, der FSGS und der Minimal-Change-Disease, der Anti-GBM-Nephritis, der ANCA-assozierten Glomerulonephritiden und der Lupusnephritis zusammen. Bislang haben diese Errungenschaften jedoch nur eine geringe Relevanz im klinischen Alltag erlangt. Es ist aber zu erwarten, dass ein besseres Verständnis einzelner Formen von Glomerulonephritiden in der Zukunft das therapeutische Repertoire bei deren Behandlung erweitert und gezieltere Therapieoptionen ermöglichen wird.

Glomerulonephritis as a disease category is one of the leading causes of end-stage renal disease in the Western world and is associated with significant morbidity and mortality. Glomerulonephritis represents a heterogeneous collection of disease entities. However, fundamental to most forms of glomerulonephritis is the immune-mediated renal damage. Some important advances, including a better understanding of genetic factors, have been achieved in the last few years and can serve as encouragement for further research in the field of glomerulonephritis. This review summarizes important genetic aspects in IgA nephropathy, membranous nephropathy, FSGS, minimal change disease, anti-GBM nephritis, ANCA-associated glomerulonephritis and lupus nephritis. We believe that this better understanding will lead to the development of new and more specific individual therapeutic strategies.

Key words

glomerulonephritis - genetic aspects - IgA nephropathy - membranous nephropathy - FSGS - minimal change disease - anti-GBM nephritis - ANCA-associated glomerulonephritis - lupus nephritis

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