膜性肾病靶抗原和免疫抑制治疗的研究进展  

Advances on the target antigens and immunosuppressive treatment in membranous nephropathy

作　　者：王一舒 王奕[1] 马晓燕[1] 王俊[1] 马姝琛[1] 刘娜[1] Wang Yishu;Wang Yi;Ma Xiaoyan;Wang Jun;Ma Shuchen;Liu Na(Department of Nephrology,Shanghai East Hospital,Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院肾内科,上海200120

出　　处：《中华肾脏病杂志》2024年第5期418-425,共8页Chinese Journal of Nephrology

基　　金：国家自然科学基金(82070791);上海市浦东新区卫生系统联合攻关项目(PW2021D-04);上海市卫生健康委员会和上海市中医药管理局项目(ZHYY-ZXYJHZX-202114);上海市浦东新区卫生系统领先人才培养计划(PWR12021-02);上海市浦东新区重点学科项目(PWZxk2022-05)。

摘　　要：膜性肾病(membranous nephropathy,MN)是以肾小球基底膜弥漫增厚伴上皮细胞下免疫复合物沉积为特点的一类肾小球疾病,传统MN的诊断主要依靠肾活检病理结果。近年来,磷脂酶A2受体、1型血小板反应蛋白7A域等MN相关生物标志物的出现改变了其诊疗模式。特异性靶抗原阳性MN患者有不同的临床表现和预后,可以指导诊断和预测预后。免疫抑制治疗是特发性MN的主要治疗方法,生物制剂等新型药物的出现是MN治疗的新进展,为特发性MN治疗提供了新选择,而继发性MN的治疗主要针对原发病。该文基于国内外最新文献,对MN靶抗原及免疫抑制治疗的研究进展进行综述,以期为该疾病的临床诊疗提供依据。Membranous nephropathy(MN)is a type of glomerular disease characterized by diffuse thickening of glomerular basement membrane with subepithelial immune complex deposition,and traditional diagnosis of MN mainly relies on the pathological results of renal biopsy.In recent years,the emergence of biomarkers related to MN such as phospholipase A2 receptor and thrombospondin type-1 domain-containing 7A has changed the diagnosis and treatment mode of MN,providing a new basis for the diagnosis,treatment and prognosis of MN.MN patients with positive specific target antigens exhibit different clinical manifestations and prognoses.Specific target antigens can not only guide diagnosis,but also has predictive value for prognosis.Immunosuppressive therapy is a common treatment for idiopathic MN patients,and the emergence of novel medications such as biologics represents a advance in the treatment of MN,providing a broader array of options for managing the condition.Conversely,the treatment approach for secondary MN primarily targets the management of the primary disease.Based on multiple and new literature,we reviewed the researches progress of target antigens and immunosuppressive therapy related to MN,so as to provide references for clinical diagnosis and treatment of MN.

关 键 词：肾小球肾炎 膜性 抗原 诊断 免疫抑制剂 

分 类 号：R692[医药卫生—泌尿科学]