Dangers Within: DAMP Responses to Damage and Cell Death in Kidney Disease

• Published in: Journal of the American Society of Nephrology Vol. 22; no. 3; pp. 416 - 425
• Main Authors: ROSIN, Diane L, OKUSA, Mark D
• Format: Journal Article
• Language: English
• Published: Washington, DC American Society of Nephrology 01.03.2011
• Subjects: Acute Disease; Adaptive Immunity - physiology; Biological and medical sciences; Cell Death - physiology; Chronic Disease; Humans; Immunity, Innate - physiology; Kidney Diseases - immunology; Kidney Diseases - physiopathology; Medical sciences; Nephrology. Urinary tract diseases; Receptors, Pattern Recognition - physiology; Toll-Like Receptors - physiology; Up Front Matters; Kidney disease; Nephrology; Urinary system disease; Nephropathy; Cell death; Lesion; Urology; Apoptosis
• ISSN: 1046-6673; 1533-3450
• DOI: 10.1681/ASN.2010040430

The response to exogenous pathogens leads to activation of innate immunity through the release of pathogen-associated molecular patterns (PAMPs) and their binding to pattern recognition receptors. A classic example is septic shock where Toll receptor 4 recognizes PAMPs. Although well accepted, this concept does not explain the activation of innate immunity and inflammation occurs with transplantation, autoimmunity, or trauma. Increasingly recognized is that endogenous molecules released by dying cells (damage-associated molecular patterns; DAMPs) activate cellular receptors leading to downstream inflammation. Thus endogenous danger signals and exogenous PAMPs elicit similar responses through seemingly similar mechanisms. Also emerging is our understanding that normal repair processes benefit from dampening the immune response to these endogenous danger molecules. Here we focus on the role of DAMPs and their putative receptors in the pathogenesis of acute and chronic kidney diseases.