Autoimmunity of patients with TINU syndrome

SummaryTubulointerstitial nephritis and uveitis (TINU) syndrome is characterized by tubulointerstitial nephritis with bilateral sudden-onset anterior uveitis. Currently, only over 200 cases have been described in the literature. TINU syndrome might be underestimated due to lack of recognition and under-diagnosis. The pathogenesis of TINU syndrome remains unclear. It has been reported to be associated with infection, drugs or autoimmune diseases. However, TINU syndrome is mostly postulated to be the result of an autoimmune process. It may involve both humoral and cellular autoimmunity, with more evidence of the latter since obvious disturbances of cell-mediated immunity have been noted in patients with TINU syndrome. Recently, autoantibodies directed against renal tubular cells have thrown new light on the role of humoral autoimmunity in TINU syndrome. It is postulated that renal tubular and ciliary body epithelia might share cross-reactive autoantigens since the major characteristics of TINU syndrome are the involvement of the kidneys and eyes, and renal tubular and ciliary body epithelia share some similar functions. This review updates the current understanding on TINU syndrome, especially its autoimmune nature.肾小管间质性肾炎-眼色素膜炎 (TINU) 综合征是一种以肾间质损伤和眼色素膜炎为主要表现的的疾病。迄今，国内外仅有 200 例左右的病例报道。由于对 TINU 综合征的认识尚浅，临床上可能漏诊了一些病例。目前其发病机制尚不明确。有报道指出 TINU 综合征与感染、药物或自身免疫疾病有关。其发病机制可能涉及体液免疫及细胞免疫。以往研究认为细胞免疫占据主导地位。近期研究发现 TINU 综合征患者血清中存在抗肾小管上皮细胞抗体，体液免疫的作用逐渐被认识。研究认为肾小管间质性肾炎及眼色素膜炎可能存在共同的免疫发病机制，即在肾、眼组织中可能存在着共同抗原。本文主要就 TINU 综合征的发病机制的一些最新进展，尤其是与自身免疫相关的部分做一简介。