ISSN: 1734-1922
Archives of Medical Science Special Issues
Current issue Archive Archives of Medical Science
3/2009
 
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abstract:

Idiopathic membranous nephropathy
Target antigens and nephritogenic antibodies in membranous nephropathy

Pierre Ronco
,
Hanna Debiec

Arch Med Sci 2009; 5, 3A: S 442–S 450
Online publish date: 2009/09/30
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Membranous nephropathy (MN), a disease characterized by an accumulation of immune deposits on the outer aspect of the glomerular basement membrane, is the most common cause of idiopathic nephrotic syndrome in Caucasian adults. In the rat model of Heymann nephritis, the target antigen of antibodies is megalin, a multiligand receptor expressed at the podocyte cell surface. This review summarizes key findings provided by this experimental model and by our discovery of neutral endopeptidase being the alloantigen involved in neonatal cases of membranous nephropathy. We discuss the role of alloimmunization as a new mechanism of renal disease and recent findings related to the identification of target antigens in adult membranous nephropathy. We believe that the substantial progress made in understanding molecular mechanisms of membranous nephropathy should lead to novel therapeutic approaches and the development of more specific biomarkers than proteinuria.
keywords:

membranous nephropathy, megalin, neutral endopeptidase, alloimmunization, complement activation

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