Tang Yuyan, He Haidong, Hu Pin, Xu Xudong
Department of Nephrology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China.
Exp Ther Med. 2020 Jul;20(1):186-194. doi: 10.3892/etm.2020.8673. Epub 2020 Apr 22.
Immunoglobulin A nephropathy (IgAN), the most common primary glomerulonephritis worldwide, is the main cause of end-stage renal disease. IgAN is characterized by the accumulation of immune complexes in the circulation, which contain abnormal levels of IgA. IgAN primarily results from galactose-deficient IgA1 (Gd-IgA1) and Gd-IgA1 deposition in the renal mesangium, causing local proliferation and matrix expansion. Gd-IgA1 has been confirmed as one of the key effectors in the pathogenesis of IgAN, but the origin of Gd-IgA1 is not clear. Recent studies have shown that Gd-IgA1 deposition could be the result of mucosally primed plasma cells and is associated with T cell dysregulation. T cells contribute to the IgA response and play an important role in the development of IgAN. In the present review, the latest discoveries regarding the role of T lymphocytes in the pathogenesis of IgAN have been summarized. Understanding these advances will allow novel therapeutic strategies for the treatment of IgAN.
免疫球蛋白A肾病(IgAN)是全球最常见的原发性肾小球肾炎,是终末期肾病的主要病因。IgAN的特征是循环中免疫复合物的积累,其中含有异常水平的IgA。IgAN主要由缺乏半乳糖的IgA1(Gd-IgA1)和Gd-IgA1在肾系膜中的沉积引起,导致局部增殖和基质扩张。Gd-IgA1已被确认为IgAN发病机制中的关键效应因子之一,但Gd-IgA1的来源尚不清楚。最近的研究表明,Gd-IgA1沉积可能是黏膜致敏浆细胞的结果,并且与T细胞失调有关。T细胞促成IgA反应,并在IgAN的发展中起重要作用。在本综述中,总结了关于T淋巴细胞在IgAN发病机制中作用的最新发现。了解这些进展将有助于开发治疗IgAN的新治疗策略。