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Idiopathic membranous nephropathy: an autoimmune disease
Sudesh P Makker1, Alfonso Tramontano
1Department of Pediatrics, University of California Davis School of Medicine, Davis, California 95616, USA. spmakker@ucdavis.edu
Seminars in Nephrology
|August 16, 2011
Summary
Research indicates idiopathic membranous nephritis (MN) is an autoimmune kidney disease. Autoantibodies targeting podocyte proteins are found in patients, contributing to immune deposits and disease progression.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- Idiopathic membranous nephritis (MN) has long been debated as an autoimmune kidney disease.
- Recent research provides substantial evidence supporting an autoimmune etiology for MN.
Purpose of the Study:
- To summarize the current understanding of the autoimmune basis of idiopathic membranous nephritis.
- To highlight the role of autoantibodies against podocyte antigens in MN pathogenesis.
Main Methods:
- Detection of autoantibodies (IgG4 subclass) against podocyte membrane proteins (PLA2R, AR, MnSOD) in patient sera and kidney tissue eluates.
- Immunoblotting and immunofluorescence microscopy to identify autoantigens and their co-localization with glomerular deposits.
Main Results:
- Autoantibodies targeting phospholipase A(2)-receptor, aldose reductase, and manganese superoxide dismutase were identified in MN patients.
- These podocyte antigens co-localized with subepithelial immune deposits in renal biopsies.
- Evidence strongly suggests autoantibodies to podocyte proteins contribute to MN pathology.
Conclusions:
- Idiopathic membranous nephritis is increasingly recognized as an autoimmune kidney disease.
- Autoantibodies against podocyte proteins are key players in the formation of immune deposits in MN.
- Further research is needed to identify primary autoantigens and understand disease triggers and progression.
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