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中华肾病研究电子杂志 ›› 2022, Vol. 11 ›› Issue (01) : 52 -56. doi: 10.3877/cma.j.issn.2095-3216.2022.01.010

综述

磷脂酶A2受体相关特发性膜性肾病研究进展
梁小雨1, 米杰2,()   
  1. 1. 250014 济南,山东中医药大学
    2. 250014 济南,山东中医药大学附属医院肾病科
  • 收稿日期:2021-08-25 出版日期:2022-02-28
  • 通信作者: 米杰
  • 基金资助:
    山东省中医药科技发展计划项目(2013ZDZK-001)

Research progress on phospholipase A2 receptor-related idiopathic membranous nephropathy

Xiaoyu Liang1, Jie Mi2,()   

  1. 1. Shandong University of Traditional Chinese Medicine
    2. Department of Nephrology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine; Jinan 250014, Shandong Province, China
  • Received:2021-08-25 Published:2022-02-28
  • Corresponding author: Jie Mi
引用本文:

梁小雨, 米杰. 磷脂酶A2受体相关特发性膜性肾病研究进展[J/OL]. 中华肾病研究电子杂志, 2022, 11(01): 52-56.

Xiaoyu Liang, Jie Mi. Research progress on phospholipase A2 receptor-related idiopathic membranous nephropathy[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2022, 11(01): 52-56.

特发性膜性肾病(IMN)是成人肾病综合征(NS)的常见病因,近年由于不断攀升的发病率及趋于年轻化的发病年龄而受到关注。M型磷脂酶A2受体(PLA2R)抗体的发现使得IMN在诊断、治疗、评估病情及判断预后等方面取得了巨大进展。我们将血清抗PLA2R抗体(PLA2Rab)及肾小球PLA2R表达阳性的IMN定义为PLA2R相关IMN。随着PLA2Rab检测技术的发展,确诊本病的患者也越来越多,其临床表现相对于其他类型的IMN往往更为严重,治疗亦较为棘手。本文就PLA2R相关IMN的研究进展进行综述,以期为临床和科研提供参考。

Idiopathic membranous nephropathy (IMN) is a common pathogeny of nephrotic syndrome in adults. In recent years, IMN has attracted much attention due to its increasing incidence and younger age of onset. The discovery of M-type phospholipase A2 receptor (PLA2R) antibody has made great progress in diagnosis, treatment, disease assessment, and prognosis judgment of IMN. We defined the IMN with both serum anti-PLA2R antibody (PLA2Rab) and glomerular PLA2R expression as PLA2R-related IMN. With the development of detection technology for serum PLA2R antibody, more and more patients have been diagnosed. Compared with other types of IMN, the clinical manifestations of PLA2R-related IMN are often more serious while its treatment is more difficult. This paper reviewed the research progress on PLA2R-related IMN in order to provide reference for both clinical work and scientific research.

图1 膜性肾病中免疫介导的足细胞损伤机制注:Ig:免疫球蛋白;MBL: mannose-binding lectin,甘露糖结合凝集素;MASP1: MASP1: mannose-associated serine protease 1,甘露糖相关丝氨酸蛋白酶1;补体可以通过三种不同的途径激活形成C5b-9补体攻击复合物,损伤足细胞导致肾损伤;同时,抗足细胞抗体可直接改变靶抗原的功能,在没有炎症的情况下触发足细胞损伤
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