Xi'an International Medical Center Hospital, Northwest University, No. 777 Xitai Road, Xi'an, Shaanxi 710000, China.
Guangdong nephrotic drug Engineering Technology Research Center, Institute of Consun Co. for Chinese Medicine in Kidney Diseases, Guangdong Consun Pharmaceutical Group, No. 71 Dongpeng avenue, Guangzhou, Guangdong 510530, China.
Int Immunopharmacol. 2023 Jul;120:110317. doi: 10.1016/j.intimp.2023.110317. Epub 2023 May 17.
Membranous nephropathy (MN) is one of the most common causes of non-diabetic nephrotic syndrome in adults. About 80% of cases are renal limited (primary MN) and 20% are associated with other systemic diseases or exposures (secondary MN). Autoimmune reaction is the main pathogenic factor of MN, and the discovery of autoantigens including the phospholipase A receptor and thrombospondin type-1 domain-containing protein 7A has led to new insights into the pathogenesis, they can induce humoral immune responses led by IgG makes them suitable for the diagnosis and monitoring of MN. In addition, complement activation, genetic susceptibility genes and environmental pollution are also involved in MN immune response. In clinical practice, due to the spontaneous remission of MN, the combination of supportive therapy and pharmacological treatment is widely used. Immunosuppressive drugs are the cornerstone of MN treatment, and the dangers and benefits of this approach vary from person to person. In summary, this review provides a more comprehensive review of the immune pathogenesis, interventions and unresolved issues of MN in the hope of providing some new ideas for clinical and scientific researchers in the treatment of MN.
膜性肾病（MN）是成人非糖尿病肾病综合征的最常见病因之一。约 80%的病例为肾脏局限性（原发性 MN），20%与其他系统性疾病或暴露有关（继发性 MN）。自身免疫反应是 MN 的主要发病因素，对包括磷脂酶 A 受体和血栓反应素型-1 域蛋白 7A 在内的自身抗原的发现，使人们对发病机制有了新的认识，它们可以诱导由 IgG 介导的体液免疫反应，使它们适合 MN 的诊断和监测。此外，补体激活、遗传易感基因和环境污染也参与了 MN 的免疫反应。在临床实践中，由于 MN 具有自发性缓解的特点，因此广泛采用支持治疗与药物治疗相结合的方法。免疫抑制剂是 MN 治疗的基石，但这种方法的危险和益处因人而异。总之，本文对 MN 的免疫发病机制、干预措施和未解决的问题进行了更全面的综述，希望为 MN 治疗的临床和科研工作者提供一些新的思路。
