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

doi:10.3877/cma.j.issn.2095-3216.2026.05.005

Abstract

Abstract:

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.

Key words: Immunoglobulin A nephropathy, Gut- kidney axis, Galactose-deficient IgA1, Mucosal immunity, Targeted therapy

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]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2026, 15(05): 274-279.

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References 47

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药物类别	药物	当前证据阶段
抗CD20单抗	利妥昔单抗	Ⅲ期随机对照试验(不推荐常规用于IgA肾病)
	奥比妥珠单抗	回顾性病例系列(3例)
抗CD38单抗	菲泽妥单抗	Ⅱa期随机对照试验
	迈泽妥单抗	Ⅰb期试验^a
蛋白酶体抑制剂	硼替佐米	前瞻性单臂试验
抗APRIL单抗	泽戈奇拜单抗	Ⅰ/Ⅱ期试验
	斯贝利单抗	Ⅲ期试验
抗BAFF单抗	贝利尤单抗	真实世界研究(回顾性队列)
BAFF/APRIL双靶点抑制剂	阿塞西普	Ⅲ期试验
	泰它西普	Ⅱ期试验
	波维塔西普	Ⅰb/Ⅱa期试验^a

药物类别	药物	当前证据阶段
抗CD20单抗	利妥昔单抗	Ⅲ期随机对照试验(不推荐常规用于IgA肾病)
	奥比妥珠单抗	回顾性病例系列(3例)
抗CD38单抗	菲泽妥单抗	Ⅱa期随机对照试验
	迈泽妥单抗	Ⅰb期试验^a
蛋白酶体抑制剂	硼替佐米	前瞻性单臂试验
抗APRIL单抗	泽戈奇拜单抗	Ⅰ/Ⅱ期试验
	斯贝利单抗	Ⅲ期试验
抗BAFF单抗	贝利尤单抗	真实世界研究(回顾性队列)
BAFF/APRIL双靶点抑制剂	阿塞西普	Ⅲ期试验
	泰它西普	Ⅱ期试验
	波维塔西普	Ⅰb/Ⅱa期试验^a

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