Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA; email:
Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA; email:
Annu Rev Med. 2024 Jan 29;75:219-332. doi: 10.1146/annurev-med-050522-034537. Epub 2023 Aug 8.
Membranous nephropathy (MN), an autoimmune kidney disease and leading cause of nephrotic syndrome, leads to kidney failure in up to one-third of affected individuals. Most MN cases are due to an autoimmune reaction against the phospholipase A2 receptor (PLA2R) located on kidney podocytes. Serum PLA2R antibody quantification is now part of routine clinical practice because antibody titers correlate with disease activity and treatment response. Recent advances in target antigen detection have led to the discovery of more than 20 other podocyte antigens, yet the clinical impact of additional antigen detection remains unknown and is under active investigation. Here we review recent findings and hypothesize how current research will inform future care of patients with MN.
膜性肾病（MN）是一种自身免疫性肾脏疾病，也是肾病综合征的主要病因，约有三分之一的患者会发展为肾衰竭。大多数 MN 病例是由于针对位于肾脏足细胞上的磷脂酶 A2 受体（PLA2R）的自身免疫反应引起的。目前，血清 PLA2R 抗体定量已成为常规临床实践的一部分，因为抗体滴度与疾病活动度和治疗反应相关。针对靶抗原检测的最新进展已经发现了 20 多种其他足细胞抗原，但额外抗原检测的临床影响尚不清楚，目前正在积极研究中。本文将综述最新研究结果，并假设当前研究将如何为 MN 患者的未来治疗提供信息。
