Division of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy.
Int J Mol Sci. 2023 Aug 23;24(17):13134. doi: 10.3390/ijms241713134.
IgA Nephropathy (IgAN) and Membranous Nephropathy (MN) are primary immune-mediated glomerular diseases with highly variable prognosis. Current guidelines recommend that greater immunologic activity and worse prognosis should guide towards the best treatment in an individualized approach. Nevertheless, proteinuria and glomerular filtration rate, the current gold standards for prognosis assessment and treatment guidance in primary glomerular diseases, may be altered with chronic damage and nephron scarring, conditions that are not related to immune activity. In recent years, thanks to the development of new molecular technologies, among them genome-wide genotyping, RNA sequencing techniques, and mass spectrometry, we have witnessed an outstanding improvement in understanding the pathogenesis of IgAN and MN. In addition, recent genome-wide association studies have suggested potential targets for immunomodulating agents, stressing the need for the identification of specific biomarkers of immune activity. In this work, we aim to review current evidence and recent progress, including the more recent use of omics techniques, in the identification of potential biomarkers for immune monitoring in IgAN and MN.
IgA 肾病 (IgAN) 和膜性肾病 (MN) 是两种主要的免疫介导性肾小球疾病，其预后具有高度变异性。目前的指南建议，在个体化治疗中，应根据更大的免疫活性和更差的预后来指导最佳治疗。然而，蛋白尿和肾小球滤过率是目前评估原发性肾小球疾病预后和指导治疗的金标准，但它们可能会因慢性损伤和肾单位瘢痕形成而改变，而这些情况与免疫活性无关。近年来，由于新技术的发展，包括全基因组基因分型、RNA 测序技术和质谱技术，我们对 IgAN 和 MN 的发病机制有了更深入的了解。此外，最近的全基因组关联研究提示了免疫调节剂的潜在靶点，强调了确定免疫活性的特异性生物标志物的必要性。在这项工作中，我们旨在回顾目前的证据和最近的进展，包括最近使用组学技术，以确定 IgAN 和 MN 中免疫监测的潜在生物标志物。
