Investigating Immune Cells in the Kidney

To Irene Chernova, MD, PhD, the kidney is an elegantly complicated organ.

“It’s fascinating in that it regulates all of our waste management and our ion homeostasis,” says Chernova, assistant professor of medicine (nephrology) at Yale School of Medicine. “These beautiful processes result in this incredibly tight regulation of homeostasis, and I admire the elegance with which the kidney handles so many things.”

Chernova combines her training in immunobiology and love of nephrology by investigating immune cells—particularly B cells—in the kidney. “It’s the perfect Venn diagram of my interests,” she says.

In a Q&A, Chernova discusses the impact of lupus on the kidneys and the role of B cells in lupus nephritis.

Lupus is a systemic autoimmune disease. In autoimmune diseases, the immune system, which is meant to attack viruses or bacteria from outside our bodies, recognizes something in our bodies as foreign and targets our own tissues and organs when it shouldn’t.

Lupus can affect any organ, but the largest major organ complication is lupus nephritis, or inflammation of the kidneys. About 50% of people with lupus will develop kidney disease, and about 10% of those individuals will go on to develop end-stage kidney damage and require kidney dialysis.

B cells are the arm of the immune system that starts making antibodies that can differentiate into antibody-producing cells. Antibodies protect us from many illnesses, but in this case, these antibodies target our own bodies. They should be targeting a virus, but they’re not.

Initially, my work focused on understanding how B cells survive in the kidney. In figuring that out, we stumbled on a way to decrease the number of these B cells in the kidney. This enabled us to study the difference between kidneys with B cells and kidneys with much fewer B cells. Currently, we are trying to find out what these B cells are doing in the kidney, which parts of the kidney they attack, and which parts are damaged. Our research suggests these B cells are damaging the glomerular basement membrane, which causes the kidney to spill protein into the urine. We aim to learn how B cells do this by comparing these two models.

I aim to gain a fundamental scientific understanding of which structures are damaged and how this immune cell is damaging those structures. Lupus is a clinically devastating disease, and we want to help people living with it.

I’m a basic scientist, so I go where my basic science brain takes me. There’s a lot more to learn at the intersection of immunology and nephrology, and I’m excited to continue working in this space.

Yale School of Medicine’s Department of Internal Medicine Section of Nephrology is committed to excellence in patient care, research, and education with the goal for both their faculty and trainees to be national and international leaders in the field of academic nephrology. To learn more about their mission and work, visit Nephrology.