Formation and rearrangement of immune complexes in the glomerulus

The majority of the immunologically mediated glomerulonephritis is caused by antibodies, which either are deposited in the glomeruli as part of immune complexes, or bind directly to glomerular structures. Such a binding may, depending on the distribution of the antigen, result in a linear or a granular binding. Therefore the principle distinction between linear and granular immunofluorescence patterns represented by the classical models of nephrotoxic serum nephritis, and serum sickness nephritis, no longer exists. Lately glomerulonephritis models have been described in which a transition from linear to granular binding occurred in the course of the disease. The linear pattern is mostly caused by the participation of antibodies directed against components of the GBM. The granular pattern may occur through a rearrangement of GBM antigens following the binding of the antibodies.