About the cover illustration
ERNEST GOODPASTURE AND GLOMERULONEPHRITIS
In 1919, Ernest Goodpasture (right) described the syndrome of rapidly-progressive glomer-ulonephritis in association with pulmonary hemorrhage. Eventually, this syndrome was found toresult from the production of antibodies against basement membrane, reacting both with theglomerular basement membrane and with that of alveoli. On renal biopsy, this type of glomer-ulonephritis may be recognized by the smooth, nearly linear deposition of immunoglobulin alongthe basement membrane. Such deposition may be nicely demonstrated by immunofluorescentstaining, as shown on the left (image may be seen in color on the J Lab Clin Med website).
It has been difficult to establish just what antigen is detected by the Goodpasture antibodies.They recognize the �3 noncollagenous domain of type IV collagen, and T-cell involvement in thedevelopment of glomerulitis suggests that linear peptides are important. A 36-amino-acid sequencefrom the carboxy terminus was thought to be the key epitope, but it cannot produce the disease byitself. An article in this month’s issue of the Journal examines overlapping peptides covering thelength of the target domain, and found that none of them would reliably produce glomerulitis inan experimental model of Goodpasture’s disease. Two peptides produced mild nephritis in aminority of animals; several could provoke a T-cell mitogenic response in animals that already hadthe syndrome. It appears that more than one antigen is necessary to produce this type of nephritis,and/or that the antigen must undergo conformational change or port-translational modification inorder to work its effect. The paper, by An-Ming Luo and colleagues, may be found on page 303.
Dale E. Hammerschmidt, MDEditor-in-Chief
Note: The glomerular image in the left panel is provided through the courtesy of the WebPath image base, maintained foreducational and teaching use by the Pathology Department of the University of Utah. We thank Dr Edward C. Klatt ofFlorida State University for permission to use this image, and we commend his collection to our readers:http://www.medlib.med.utah.edu/webpath/webpath.html.
J Lab Clin Med 2002;139:324.
Copyright © 2002 by Mosby, Inc.
0022-2143/2002 $35.00 � 0 5/8/124553
doi:10.1067/mlc.2002.124553
324