, Volume 44, Issue 2, pp 635-638
Date: 20 Dec 2011

A novel link: in children, cow milk processing may be causative of idiopathic membranous nephropathy

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Summary of key findings

A causative pathway for ‘idiopathic’ membranous nephropathy (MN) in children has been unraveled by Debiec et al. [1], linking immunization to cationic bovine albumin with antibody generation and subepithelial immune complex depositions. The work performed reads like a mystery story with unexpected revelations, well suited to serve as exemplary for translational research and the integrities that one may encounter. The highlighted article by Debiec et al. [1] describes a mechanism of membranous nephropathy (MN) triggered by circulating cationic bovine serum albumin (cBSA). In four children (aged < 3 years) diagnosed with MN, cBSA serum levels were associated with high titer of anti-cBSA autoantibodies in serum samples. Epitope testing with peptide libraries defined a cBSA subdomain (aa 147–161) as crucial for antibody generation. This domain is a substrate of trypsin acting in the gut and however may potentially evade cleavage due to food processing. Cationic BSA i ...