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Update on immunoglobulin A nephropathy, Part I: Pathophysiology
Maurizio Salvadori1, Giuseppina Rosso1
1Maurizio Salvadori, Department of Transplantation and Renal Diseases, Careggi University Hospital, 50139 Florence, Italy.
World Journal of Nephrology
|September 18, 2015
Summary
Immunoglobulin A (IgA) nephropathy, a common kidney disease, is linked to autoantibodies against poorly O-glycosylated IgA1. Further research is needed to clarify its pathogenesis, including infection triggers and deposition mechanisms.
Area of Science:
- Nephrology
- Immunology
- Genetics
Background:
- Immunoglobulin A (IgA) nephropathy is a prevalent glomerulonephritis, often with an indolent course, necessitating kidney biopsy for diagnosis.
- Recent advances have improved understanding of IgA nephropathy pathogenesis, yet key questions persist regarding genetic factors, infectious triggers, and immune complex formation.
Purpose of the Study:
- To review current knowledge on IgA nephropathy pathogenesis, highlighting genetic associations and remaining uncertainties.
- To discuss the role of autoantibodies to poorly O-glycosylated IgA1 and potential infectious triggers.
Main Methods:
- Review of genetic wide association studies identifying relevant genes and explaining ancestral group prevalence.
- Analysis of current understanding regarding autoantibodies against immunoglobulin A1 (IgA1) and the role of mucosal infections.
- Discussion of ongoing debates concerning immune complex deposition and the link to podocyte injury and tubulointerstitial scarring.
Main Results:
- Genetic studies confirm the relevance of genetics in IgA nephropathy, identifying several candidate genes and explaining ethnic variations.
- Autoantibodies against poorly O-glycosylated IgA1 are central to IgA nephropathy pathogenesis.
- The precise role of specific pathogens and Toll-like receptor polymorphisms requires further elucidation.
Conclusions:
- IgA nephropathy pathogenesis is multifactorial, involving genetic predisposition and immune responses to altered IgA1.
- Clarification of infectious triggers, immune complex deposition mechanisms, and downstream cellular injury is crucial for advancing treatment strategies.
Keywords:
Auto antibodiesComplement in renal diseasesGenome-wide association studiesImmunoglobulin AImmunoglobulin A galactosylationMesangial linked growth factorsMore Related Videos
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