What is new in the pathogenesis and treatment of IgA glomerulonephritis  

作　　者：Maurizio Salvadori Giuseppina Rosso 

机构地区：[1]Department of Renal Transplantation,Careggi University Hospital,Florence 50139,Tuscany,Italy [2]Division of Nephrology,San Giovanni di Dio Hospital,Florence 50143,Toscana,Italy

出　　处：《World Journal of Nephrology》2024年第4期13-27,共15页世界肾病学杂志（英文）

摘　　要：Recently,new findings have been clarified concerning both pathogenesis and treatment of IgA nephritis.The four hits theory has been confirmed but several genetic wide association studies have allowed finding several genes connected with the pathogenesis of the disease.All these new genes apply to each of the four hits.Additionally,new discoveries concerning the microbiota and its connection with immune system and IgA generation have allowed finding out the role of the mucosa in IgA nephropathy pathogenesis.The IgA treatment is also changed included the future possibilities.The treatment of the chronic kidney disease,associated with the nephropathy,is mandatory,since the beginning of the disease.The classical immunosuppressive agents have poor effect.The corticosteroids remain an important cornerstone in any phase of the disease.More effect is related to the treatment of B cells and plasma cells.In particular,in very recent studies have been documented the efficacy of anti B cell-activating factor and anti A proliferation-inducing ligand agents.Most of these studies are to date in phase II/III.Finally,new agents targeting complement are arising.These agents also are still in randomized trials and act principally in hit 4 where the immunocomplexes in the mesangium activate the different pathways of the complement cascade.

关 键 词：IgA nephropathy Anti IgA autoantibodies Genetic wide association studies Microbiota Anti B cell-activating factor agents Anti A proliferation-inducing ligand agents Anti complement agents 

分 类 号：R692.3[医药卫生—泌尿科学]