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Membranous Nephropathy: Antigenic Landscape and a Novel Pathogenetic Model
Irina Zdravkova1,2, Eduard Tilkiyan2,3, Desislava Bozhkova4,5
1Department of Propaedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
International Journal of Molecular Sciences
|March 14, 2026
Summary
Membranous nephropathy pathogenesis remains unclear. This review proposes a model categorizing antigens and complement activation pathways to help distinguish primary from secondary forms of this kidney disease.
Area of Science:
- Nephrology
- Immunology
- Pathogenesis
Background:
- Membranous nephropathy's etiopathogenesis is not fully understood.
- Distinguishing primary and secondary forms is challenging.
- New antigen/antibody discoveries add diagnostic ambiguity.
Purpose of the Study:
- To review newly discovered antigens and antibodies in membranous nephropathy.
- To propose a pathogenetic model.
- To differentiate primary and secondary forms.
Main Methods:
- Literature review of new antigens and antibodies.
- Development of a pathogenetic model.
- Categorization of antigens by immunoglobulin deposits and complement pathways.
Main Results:
- A model is proposed linking antigens to immunoglobulin deposits and complement pathways.
- The model helps differentiate primary and secondary membranous nephropathy.
- Activation of lectin and classical complement pathways by foreign antigens is highlighted.
Conclusions:
- The proposed model aids in clarifying membranous nephropathy pathogenesis.
- Understanding complement activation pathways is key to differentiating disease forms.
- This approach may improve diagnosis and therapeutic strategies.
