a III. Department of Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
Expert Rev Clin Immunol. 2019 Feb;15(2):165-175. doi: 10.1080/1744666X.2019.1548934. Epub 2018 Nov 27.
: Membranous nephropathy (MN) is the most common cause of a nephrotic syndrome in Caucasian adults. The identification of target antigens in MN in the last decade has had a major impact on the clinical approach to these patients. : Since the discoveries in animal models in the 1980s that circulating autoantibodies induce disease upon in situ binding to glomerular podocytes, many attempts have been undertaken to define the human antigens responsible for disease induction. Only in 2009 was Phospholipase A Receptor 1 described as the major antigen responsible for MN onset in about 70% of patients. Subsequently, in 2014, Thrombospondin Type-1 Domain-Containing 7A was identified as a second antigen, accounting for 2-3% of patients with MN. The knowledge of the role of these antibodies in MN has improved the diagnosis and management of patients and helped to better define the need for immunosuppressive treatment. : These discoveries over the last 10 years in the discipline of nephrology have clearly shown the improvements a better understanding of disease pathogenesis can bring for patient care.
膜性肾病（MN）是导致白种人成年人肾病综合征的最常见原因。在过去十年中，MN 中靶抗原的鉴定对这些患者的临床治疗方法产生了重大影响。自 20 世纪 80 年代在动物模型中的发现以来，循环自身抗体在原位与肾小球足细胞结合后会诱导疾病，人们已经做出了许多尝试来确定导致疾病发生的人类抗原。直到 2009 年，磷脂酶 A2 受体 1 才被描述为导致约 70%的 MN 发病的主要抗原。随后，在 2014 年，血小板反应蛋白 1 型域包含 7A 被确定为第二种抗原，占 MN 患者的 2-3%。这些抗体在 MN 中的作用的知识提高了对患者的诊断和管理，并有助于更好地定义免疫抑制治疗的需求。在过去 10 年的肾脏病学领域中，这些发现清楚地表明，对疾病发病机制的更好理解可以为患者护理带来改善。
