Division of Nephrology, Denver Health Medical Center, Denver, CO, USA.
Division of Renal Disease and Hypertension, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Kidney Int. 2024 Jan;105(1):54-64. doi: 10.1016/j.kint.2023.09.024. Epub 2023 Oct 29.
The neonatal Fc receptor (FcRn) was initially discovered as the receptor that allowed passive immunity in newborns by transporting maternal IgG through the placenta and enterocytes. Since its initial discovery, FcRn has been found to exist throughout all stages of life and in many different cell types. Beyond passive immunity, FcRn is necessary for intrinsic albumin and IgG recycling and is important for antigen processing and presentation. Given its multiple important roles, FcRn has been utilized in many disease treatments including a new class of agents that were developed to inhibit FcRn for treatment of a variety of autoimmune diseases. Certain cell populations within the kidney also express high levels of this receptor. Specifically, podocytes, proximal tubule epithelial cells, and vascular endothelial cells have been found to utilize FcRn. In this review, we summarize what is known about FcRn and its function within the kidney. We also discuss how FcRn has been used for therapeutic benefit, including how newer FcRn inhibiting agents are being used to treat autoimmune diseases. Lastly, we will discuss what renal diseases may respond to FcRn inhibitors and how further work studying FcRn within the kidney may lead to therapies for kidney diseases.
新生儿 Fc 受体（FcRn）最初被发现是一种受体，它可以通过胎盘和肠上皮细胞将母体 IgG 转运到新生儿体内，从而实现被动免疫。自最初发现以来，人们发现 FcRn 存在于生命的各个阶段和许多不同的细胞类型中。除了被动免疫外，FcRn 还参与内源性白蛋白和 IgG 的再循环，并且对抗原加工和呈递很重要。鉴于其多种重要作用，FcRn 已被用于许多疾病的治疗，包括一类新的药物，这些药物被开发出来是为了抑制 FcRn 以治疗各种自身免疫性疾病。肾脏内的某些细胞群体也表达高水平的这种受体。具体来说，足细胞、近端肾小管上皮细胞和血管内皮细胞已被发现利用 FcRn。在这篇综述中，我们总结了已知的关于 FcRn 及其在肾脏中的功能。我们还讨论了 FcRn 如何被用于治疗益处，包括新型 FcRn 抑制药物如何被用于治疗自身免疫性疾病。最后，我们将讨论哪些肾脏疾病可能对 FcRn 抑制剂有反应，以及对肾脏中 FcRn 的进一步研究如何为肾脏疾病的治疗提供线索。
