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Extra info for Age-Related Macular Degeneration, 2nd Edition
External to the podocyte is Bowman’s capsule (conceptually corresponding to the subretinal space). Smooth muscle cells located internally to the endothelium, called mesangial cells, are responsible for regulating contractility and maintaining the glomerular matrix. These cells may share analogies with choroidal pericytes underlying and surrounding the choriocapillaris. Innate Immunity in Glomerular Diseases Chronic Injury As is the case for atherosclerosis, a response to injury hypothesis has been substantiated for glomerulosclerosis due to aging, hypertension or diabetes (138–145).
Antibodies then mediate a variety of immune effector activities by binding to antigen in the blood or in tissues. Antibodies serve as effectors of tissue-speciﬁc immune responses by four main mechanisms. Intravascular circulating antibodies can bind antigen in the blood, thereby form circulating immune complexes (ICs). Then the entire complex of antigen plus antibody can deposit into tissues. Alternatively, circulating B cells can inﬁltrate into a tissue and secrete antibody locally to form an IC.
The pathology of atherosclerosis suggests a spectrum of changes whose pathogenesis may be relevant to the understanding of AMD (107,108). The fatty streak, representing the earliest phase of atherosclerosis, is characterized by lipid deposition and macrophage inﬁltration within the vessel wall (101,108,109). Some investigators have suggested similarities in pathogenesis between fatty streak formation and early AMD (110). The fatty streak can progress into the ﬁbrous plaque, characterized by the proliferation of smooth muscle cells, increasing inﬂammation, and formation of connective tissue with neovascularization within the vessel wall.