However, it becomes increasingly common to view pathogenesis of diseases as an interplay between genetics and environment. Nelson and Alpers summed up progress in identifying environmental factors contributing to pathogenesis of the three common glomerular diseases.
- Bovine serum albumin (BSA) was identified in some patients with membranous nephropathy (MN). The cow-derived protein colocalized with subepithelial immune complex in a fraction of MN cases.
- It was assumed that a mysterious circulating factor is responsible for FSGS. The agent is now unveiled to be suPAR (soluable urokinase plasminogen activator receptor). It was induced by chronic, low-level infection of commensal or noncommensal bacteria.
- The dysregulated nutrient environment of diabetes stimulates mTOR pathway of podocytes contributing to diabetic nephropathy.
