Abstrakt

An explanatory framework connecting immunology to primary membranous nephropathy

Brain Stewart

Immune deposits, principally Immunoglobulin (IgG) and complement are deposited under the epithelium in Membranous Nephropathy (MN), the major cause of nephrotic syndrome in adults. With the capacity to test circulating autoantibodies to PLA2R and the discovery that the Phospholipase A2 Receptor (PLA2R) is the target antigen in the majority of cases, the field made significant progress. Since then, evidence for the existence of new target antigens such as semaphorin 3B, exostosins 1 and 2, neural EGFL like 1 and thrombospondin type 1 domain containing 7A has been presented. The humoral component of primary membranous nephropathy has become clearer with the capacity to identify and track the levels of circulating autoantibodies. Approximately 75% of all MN in developed nations are idiopathic or primary; the remaining 20%-25% are secondary to variable circumstances, such as infections (HBV, hepatitis B and C, HIV infection, malaria, etc.), malignant neoplasms (lung, breast, stomach and prostate cancer, lymph proliferative disorder, etc.) and systemic autoimmune diseases.