The past decade has seen remarkable progress in our understanding of the immunologic responses associated with diseases of the kidney. In particular, the diversity of bone marrow-derived immune cells present in the kidney during health and disease has been detailed by many laboratories using animal models and human biospecimens. As a result, we can now clearly distinguish the major classes of intrarenal immune effector cells (mononuclear phagocytes, polymorphonuclear leukocytes, T cells, B cells, and innate lymphocytes) as well as relevant subclasses of each-for instance, monocytes, macrophages, and dendritic cells (DCs) within the mononuclear phagocyte family.1 Additionally, small animal-based studies have further subclassified immune cell types within the kidney based on their finer phenotypic details and functional characteristics-a good example being the various effector programs that predominate among intrarenal CD4 1 helper T cells (Th1, Th2, Th17, and regulatory) during different disease processes.
2A key element of recent progress has been the incorporation of emerging concepts and knowhow from the field of basic immunology into renal research. Notably, techniques such as multicolor flow cytometry, bone marrow chimerism, model antigen systems, adoptive cell transfer, and cell typespecific knockout and transgenic mice have opened the door to detailed dissections of intrarenal immunologic responses in the context of disease models.
1To a degree, however, our progress in renal immunology has been uneven, with a heavy emphasis on certain rodent models of AKI and acute GN as well as a strong focus on innate (nonantigen-specific) responses occurring within the kidney itself or adaptive (T cell and antibody) responses for which the antigen presentation pathways are unclear.1 Although these preferences are understandable on the basis of the clinical importance of AKI and GN coupled with the availability of suitable models, there are some potentially fascinating areas that remain underexplored. Two such areas are the study of the kidney and its draining lymph node as an immunologic axis and the mechanisms by which immune tolerance is maintained to antigens that are either exclusively expressed by cells of the kidney or become concentrated within the renal interstitium as a result of glomerular filtration and reuptake.In the current issue of JASN, a study from the laboratory of Christian Kurts elegantly addresses these two issues using a very precise set of experimental approaches from the mouse immunology toolbox.3 In a simple but revealing first experiment, Gottschalk et al. 3 show that fluorescent ovalbumin is taken up within 10 minutes of intravenous injection by a substantially higher proportion of the DCs in renal lymph nodes (RLNs) than other lymph nodes. The timing of this observation, together with previously published work from the same group, 4 indicates that intravascular ovalbumin is filtered in the kidney and reabsorbed into the interstitium from where it is quickly carried by lymphatics to the RLN...