Kwatra Ishwardip Singh, Prasher P K
J Assoc Physicians India. 2013 Nov;61(11):807-10.
Membranous nephropathy (MN) is the most common cause of adult nephrotic syndrome and it accounts for about 25% of renal biopsies done for this syndrome. Most of the cases are primary or idiopathic in nature while only about one third of the cases are secondary to some known disease.This review describes the recent advances regarding pathogenesis. Membranous nephropathy is an organ specific autoimmune disease. Experimental studies in late 1950s using rat models (Heymann Nephritis) has provided much understanding of pathogenesis of the disease. Role of in situ formation of immune complexes and involvement of complement system was established. Recently the M-type phospholipase A2 receptor (PLA2R) has been identified as target antigen in humans. High titre anti-bovine serum albumin antibodies have been found in children with this disease. It is hoped that in near future non invasive diagnosis and individualised therapy may become a reality.
膜性肾病（MN）是成人肾病综合征最常见的病因，约占为此综合征进行肾活检病例的25%。大多数病例本质上是原发性或特发性的，而只有约三分之一的病例继发于某些已知疾病。本综述描述了关于发病机制的最新进展。膜性肾病是一种器官特异性自身免疫性疾病。20世纪50年代后期使用大鼠模型（海曼肾炎）进行的实验研究对该疾病的发病机制有了很多了解。免疫复合物原位形成的作用以及补体系统的参与得以确立。最近，M型磷脂酶A2受体（PLA2R）已被确定为人类的靶抗原。在患有这种疾病的儿童中发现了高滴度的抗牛血清白蛋白抗体。希望在不久的将来，无创诊断和个体化治疗能够成为现实。
