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中华肾病研究电子杂志 ›› 2026, Vol. 15 ›› Issue (05) : 274 -279. doi: 10.3877/cma.j.issn.2095-3216.2026.05.005

综述

肠-肾轴在IgA肾病发病机制与靶向治疗中的作用研究进展
王佳怡, 杨敏, 何晓琳, 魏佳琪, 伍刚†()   
  1. 215002 南京医科大学附属苏州医院肾内科
  • 收稿日期:2025-12-14 出版日期:2026-10-28
  • 通信作者: 伍刚
  • 基金资助:
    苏州市基础研究计划-医学应用基础研究(SKY2023206)

Research progress on the role of gut-kidney axis in the pathogenesis and targeted therapy of IgA nephropathy

Jiayi Wang, Min Yang, Xiaolin He, Jiaqi Wei, Gang Wu†()   

  1. Department of Nephrology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215002, Jiangsu Province, China
  • Received:2025-12-14 Published:2026-10-28
  • Corresponding author: Gang Wu
引用本文:

王佳怡, 杨敏, 何晓琳, 魏佳琪, 伍刚. 肠-肾轴在IgA肾病发病机制与靶向治疗中的作用研究进展[J/OL]. 中华肾病研究电子杂志, 2026, 15(05): 274-279.

Jiayi Wang, Min Yang, Xiaolin He, Jiaqi Wei, Gang Wu. Research progress on the role of gut-kidney axis in the pathogenesis and targeted therapy of IgA nephropathy[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2026, 15(05): 274-279.

免疫球蛋白A(immunoglobulin A,IgA)肾病是最常见的原发性肾小球疾病,亦是导致终末期肾病的主要原因之一。近年来,肠-肾轴成为IgA肾病发病机制的研究热点。越来越多研究表明,IgA肾病的发生与肠道菌群失调、肠黏膜屏障破坏、黏膜免疫异常激活及肠道微生物代谢产物紊乱密切相关。本综述系统梳理肠-肾轴在IgA肾病发病机制中的最新研究进展,总结基于肠-肾轴的新型干预策略,包括饮食调控、肠道微生物干预、黏膜免疫调节及靶向B细胞/浆细胞生物制剂,并归纳可通过调控肠-肾轴获益的传统治疗手段,以期为IgA肾病个体化防治提供理论依据与研究新思路。

Immunoglobulin A (IgA) nephropathy is the most common primary glomerular disease and one of the leading causes of end-stage kidney disease. In recent years, the gut-kidney axis has become a research hotspot in the pathogenesis of IgA nephropathy. Accumulating studies have demonstrated that the onset of IgA nephropathy is closely associated with gut microbiota dysbiosis, disruption of the intestinal mucosal barrier, aberrant mucosal immune activation, and disturbed gut microbial metabolites. This review systematically summarizes the latest research progress regarding the gut-kidney axis in the pathogenesis of IgA nephropathy, and outlines novel intervention strategies based on the gut-kidney axis, including dietary modulation, gut microbiota intervention, mucosal immune regulation, and biologic agents targeting B-cells/plasma cells. Conventional therapeutic approaches that may exert benefits via modulating the gut-kidney axis are also summarized, so as to provide theoretical evidence and new research insights for individualized prevention and treatment of IgA nephropathy.

表1 靶向B细胞/浆细胞的IgA肾病治疗药物
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