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The pathobiology of the mesangium

Kidney International, ISSN: 0085-2538, Vol: 41, Issue: 3, Page: 524-529
1992
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Although Marcello Malpighi in 1666 was the first to call attention to the glomerulus as an important part of the mammalian kidney, it was not until the detailed microscopic observations of von Möllendorf and Zimmermann around 1930 that the central or axial, connective tissue-like space of the glomerular capillary tuft was distinguished from the glomerular endothelial and epithelial cell layers. This inter- or pericapillary region, harboring a “third cell” type, came to be known as the mesangium and became a focus of investigative interest for students of glomerular morphology, function and pathobiology [reviewed in 1]. To pathologists and nephrologists, it has been a most important finding that the expansion of the mesangium, due to increases in cellularity and extracellular matrix, is a prominent histologic abnormality in all types of chronic, progressive glomerular disease. The proliferative response in the human mesangium is most pronounced in diseases such as mesangiocapillary glomerulonephritis and IgA nephropathy. The sclerotic response as characterized by the accumulation of mesangial matrix, is a common feature of all advanced glomerular lesions and is especially prominent in diabetic nephropathy and chronic diseases such as focal and segmental glomerulosclerosis. In view of the obvious involvement of the mesangium in the pathogenesis of glomerular disease, it is important to understand the mechanisms which control the behavior of mesangial cells under physiological and abnormal conditions.

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