期刊
FRONTIERS IN IMMUNOLOGY
卷 12, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.593288
关键词
membranous nephropathy; anti-PLA2R antibodies; anti-THSD7A antibody; remission; outcome
类别
资金
- research initiative of the Ministry of Health of Czech Republic [RVO-VFN 64165]
The discovery of anti-podocyte antibodies in primary membranous nephropathy has significantly impacted the diagnosis, treatment, and prognosis of this disease. Evaluation of serum levels of these antibodies allows for non-invasive diagnosis, prediction of renal outcomes, and personalized treatment. However, further research is needed to understand the relationship between anti-podocyte antibodies and cancer, the risk of MN recurrence before renal transplantation, and the implications of antibodies against minor antigens.
The discovery of anti-podocyte antibodies in primary membranous nephropathy (MN) has revolutionized our approach toward the diagnosis and treatment of this disease. Evaluation of serum levels of anti-podocyte antibodies paved the way for non-invasive diagnosis and helped distinguish between primary and secondary MN although the relationship between anti-podocyte antibodies and cancer remains to be elucidated. Serum levels of anti-PLA2R antibodies directed against the major podocyte autoantigen are related to MN activity and the decrease in serum levels of anti-PLA2R antibodies in response to treatment (immunologic remission) also serves as an early indicator of the later putative proteinuric remission, enabling personalization of the treatment. The serum levels of anti-podocyte antibodies also enable the prediction of renal outcomes in terms of both remission and the risk of progression to end-stage renal disease. The positivity of anti-PLA2R antibodies before renal transplantation is associated with the risk of recurrence of MN. It remains to be established if all these relations observed in patients with anti-PLA2R antibodies are also valid for expanding spectrum of antibodies directed against recently discovered minor antigens (e.g., THSD7A, NELL-1, semaphorin 3B).
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