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Advances in Complement-Targeted Therapy for IgA Nephropathy.

Min Lu1, Guisen Li1

  • 1Department of Nephrology and Nephrology Institute, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Kidney Diseases (Basel, Switzerland)
|January 29, 2026
PubMed
Summary
This summary is machine-generated.

IgA nephropathy (IgAN) involves the complement system, particularly the alternative pathway. Complement-targeted therapies show promise for IgAN treatment but require further research for patient selection and efficacy.

Keywords:
Alternative pathwayComplement inhibitorIgA nephropathyLectin pathway

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Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • IgA nephropathy (IgAN) is a primary cause of renal failure in young Chinese individuals.
  • Disease heterogeneity complicates targeted drug development for IgAN.
  • The complement system's role in IgAN pathogenesis is increasingly recognized.

Purpose of the Study:

  • To review the association between IgA nephropathy and the complement system.
  • To summarize advancements in complement-targeted therapies for IgAN.
  • To discuss challenges and future directions in this therapeutic area.

Main Methods:

  • Systematic review of literature on IgAN and complement system interactions.
  • Analysis of the four-hit hypothesis in IgAN pathogenesis.
  • Evaluation of current clinical trial data for complement inhibitors in IgAN.

Main Results:

  • The alternative complement pathway is a key contributor to IgAN, though other pathways are also involved.
  • Several complement inhibitors targeting the cascade are in clinical trials with varied efficacy.
  • Challenges include patient stratification, long-term safety, and cost-effectiveness.

Conclusions:

  • Complement-targeted therapy offers a novel treatment strategy for IgAN.
  • Overcoming barriers in patient selection and demonstrating long-term efficacy are crucial.
  • Developing biomarkers and conducting large-scale trials are necessary for precision therapy.