The glomerular mesangium is composed of mesangial cells and an intercellular material, the mesangial matrix. Partly because of its unique anatomic location, the mesangium appears to be susceptible to immune- and non-immune-mediated injury. Mesangial cells have characteristics similar to smooth muscle cells, and their surface is covered with receptors that bind a variety of vasoactive substances. The glomerular mesangium seems to play an important role in the physiologic regulation of the glomerular microcirculation. There is evidence that a plasmic flow carrying macromolecules circulates through the mesangium. Changes in glomerular hemodynamic determinants and in the release and/or production of vasoactive substances, particularly angiotensin II, can greatly influence the mesangial movement of macromolecules. Quantitative and/or qualitative alterations in the mesangial movement of macromolecules may lead to mesangial injury.
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