New horizons in transplantationReview articleGlomerular Diseases and Renal Transplantation: Pathogenic Pathways and Evolution of Therapeutic Interventions

- Glomerular diseases and renal transplantation share common pathogenic mechanisms.
- Innate and adaptive immunity, as well as auto- and allo-immune responses, are implicated in the pathogenesis of glomerulopathies and allograft injury.
- New therapies against selective targets of the immune system can be used in both entities.

Glomerular diseases and renal transplantation are the main fields of nephrology in which the immune system plays a prevalent role. Glomerular diseases have traditionally been attributed to auto-immune conditions, whereas allograft rejection has been considered an allo-immune response. However, common immunopathologic mechanisms that include Toll-like receptors, complement and B-cell activation, as well as genetic and infectious factors appear to be involved in the pathogenesis of both entities. Novel therapeutic regimens directed against specific targets of the immune system show promising results in glomerulopathies as well as in renal transplantation.