Abstract
Membranous nephropathy, 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 white 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 the approach that we use to identify new podocyte antigens. We also summarize current knowledge on the mechanism of proteinuria, with special emphasis on the role of complement. In conclusion, substantial progresses have been made in understanding molecular mechanisms of membranous nephropathy, which should lead to novel therapeutic approaches.
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Acknowledgment
The research of the authors is funded by grants from GIS-Institut des Maladies Rares, Agence de la Biomédecine, Programme Hospitalier de Recherche Clinique, INSERM, Fondation pour la Recherche Médicale, AURA (Association pour l’Utilisation du Rein Artificiel), AMGEN France, and Genzyme Renal Innovations Program (GRIP). We thank Christine Vial for assistance in editing the manuscript.
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Ronco, P., Debiec, H. Target antigens and nephritogenic antibodies in membranous nephropathy: of rats and men. Semin Immunopathol 29, 445–458 (2007). https://doi.org/10.1007/s00281-007-0091-2
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DOI: https://doi.org/10.1007/s00281-007-0091-2