[What is new in nephrotic syndrome?]

This paper reviews the recent achievements in our understanding of glomerular and tubulointerstitial cell biology, their function and disfunction as well as the role in the pathogenesis of the glomerular diseases, namely the nephrotic syndrome. What is new is a major change in our general view of immune inquiry of the tissues. It has been realized that, far from being simple recipients of iqurious stimuli, the cells of the organ may participate in the events of injury in active ways: secretion of cytokinese, eicosanoides, growth factors, complement components, expression of procoagulant factors, MHC class I and II molecules and adhesion molecules. Although we understand much more about pathogenesis of the nephrotic syndrome, this additional knowledge has not resulted, so far, in better treatment. For the time being there are only attempts to improve treatment by affecting mediators (cytokines, growth factors), inhibit cell signaling or cell to cell contact.