Liu Wenbin, Huang Guangrui, Rui Hongliang, Geng Jie, Hu Haikun, Huang Yujiao, Huo Guiyang, Liu Baoli, Xu Anlong
School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.
Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China; Beijing Institute of Traditional Chinese Medicine, Beijing, China.
Autoimmun Rev. 2022 Feb;21(2):102976. doi: 10.1016/j.autrev.2021.102976. Epub 2021 Oct 29.
A variety of podocyte antigens have been identified in human membranous nephropathy (MN), which is divided into various antigen-dominated subtypes, confirming the concept that MN is the common pattern of glomerular injury in multiple autoimmune responses. The detection of autoantibodies, which has been widely used in the clinical practice of MN, may lead to personalized precision medicine. However, given the potential risks of immunosuppressive therapy, more autoantibodies and biomarkers need to be identified to predict the prognosis and therapeutic response of MN more accurately. In this review, we attempted to summarize the autoantigens/autoantibodies and autoimmune mechanisms that can predict disease states based on the current understanding of MN pathogenesis, especially the podocyte injury manifestations. In conclusion, both the autoimmune response and podocyte injury require multidimensional attention in the disease course of MN.
在人类膜性肾病（MN）中已鉴定出多种足细胞抗原，该病可分为多种以抗原为主导的亚型，这证实了MN是多种自身免疫反应中肾小球损伤的常见模式这一概念。自身抗体检测已广泛应用于MN的临床实践，可能会带来个性化精准医疗。然而，鉴于免疫抑制治疗的潜在风险，需要识别更多的自身抗体和生物标志物，以更准确地预测MN的预后和治疗反应。在本综述中，我们试图根据目前对MN发病机制的理解，特别是足细胞损伤表现，总结能够预测疾病状态的自身抗原/自身抗体和自身免疫机制。总之，在MN的病程中，自身免疫反应和足细胞损伤都需要多维度关注。
