Cell-mediated autoimmunity and HLA in anti-glomerular basement membrane disease

Anti-glomerular basement membrane (anti-GBM) disease arises when the immune system attacks a protein called α3(IV)NC1, found in small blood vessels in kidneys and lungs. Inflammation in the kidneys (glomerulonephritis) can rapidly cause kidney failure, and, in the lungs, life-threatening haemorrhage. Anti-GBM (or ‘Goodpasture’) disease is diagnosed by detecting anti-α3(IV)NC1 antibodies in blood samples and kidney biopsies. T cells are also important drivers of autoimmunity, but less readily measured clinically. This thesis defines the distinct features of T cells targeting α3(IV)NC1, showing that target-specific T cells are critical in this and other autoimmune diseases, with potential to guide monitoring and treatment.