Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan.
Department of Nephrology, Juntendo University Urayasu Hospital, Chiba 279-0021, Japan.
Int J Mol Sci. 2024 Oct 25;25(21):11484. doi: 10.3390/ijms252111484.
IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis worldwide; however, the underlying mechanisms of this disease are not fully understood. This review explores several animal models that provide insights into IgAN pathogenesis, emphasizing the roles of aberrant IgA1 glycosylation and immune complex formation. It discusses spontaneous, immunization, and transgenic models illustrating unique aspects of IgAN development and progression. The animal models, represented by the grouped ddY (gddY) mouse, have provided guidance concerning the multi-hit pathogenesis of IgAN. In this paradigm, genetic and environmental factors, including the dysregulation of the mucosal immune system, lead to increased levels of aberrantly glycosylated IgA, nephritogenic immune complex formation, and subsequent glomerular deposition, followed by mesangial cell activation and injury. Additionally, this review considers the implications of clinical trials targeting molecular pathways influenced by IgAN (e.g., a proliferation-inducing ligand [APRIL]). Collectively, these animal models have expanded the understanding of IgAN pathogenesis while facilitating the development of therapeutic strategies that are currently under clinical investigation. Animal-model-based studies have the potential to facilitate the development of targeted therapies with reduced side effects for IgAN patients.
IgA 肾病(IgAN)是全球最常见的原发性肾小球肾炎类型;然而,这种疾病的潜在机制尚未完全阐明。本综述探讨了几种动物模型,这些模型深入了解了 IgAN 的发病机制,强调了异常 IgA1 糖基化和免疫复合物形成的作用。文中讨论了自发性、免疫接种和转基因模型,这些模型说明了 IgAN 发展和进展的独特方面。以分组 ddY(gddY)小鼠为代表的动物模型为 IgAN 的多打击发病机制提供了指导。在这种模式下,遗传和环境因素,包括黏膜免疫系统的失调,导致异常糖基化 IgA 的水平升高、肾炎性免疫复合物的形成以及随后的肾小球沉积,接着是系膜细胞的激活和损伤。此外,本综述还考虑了针对 IgAN 影响分子途径的临床试验的意义(例如,增殖诱导配体 [APRIL])。总之,这些动物模型扩展了对 IgAN 发病机制的理解,同时促进了治疗策略的发展,这些策略目前正在临床研究中。基于动物模型的研究有可能为 IgAN 患者开发具有较少副作用的靶向治疗方法。