Mast Cells in Kidney Regeneration

Publisher Summary This chapter reviews the knowledge that has accumulated on the role of MCs in renal disease, with a particular emphasis on their roles in repair and regeneration. Chronic kidney disease (CKD) is a growing health problem worldwide as it leads to the development of renal failure with no treatment options except for replacement therapy. CKD can be caused by disorders that affect any of the kidney structures, including glomeruli, renal vessels, and the tubulointerstitial compartment. They are either genetically inherited, e.g. autosomal dominant polycystic kidney disease, or acquired. The latter can arise in response to toxic, metabolic (diabetes), hemodynamic (hypertension), postischemic, infectious or autoimmune injury leading to damage of renal tissue. Independent of its origin, the initial injury launches an inflammatory cascade to oppose the injurious insult and initiate tissue repair with eventually limited fibrosis and epithelial regeneration. While initially studied for their role in allergies, research in the past two decades has revealed that MCs are highly versatile effector cells with multiple roles in innate and adaptive immunity as well as in the inflammatory processes. Although initially thought to contribute to the pathogenesis of renal diseases, several recent experimental evidences using MC-deficient mice favor a more subtle view. They indicated that MCs can also have beneficial roles in the reparation and tissue remodeling processes that accompany healing.