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Seminars in Immunopathology
Published in: Seminars in Immunopathology 4/2014

01-07-2014 | Review

New insights into the pathogenesis of IgA nephropathy

Authors: Jürgen Floege, Ivan C. Moura, Mohamed R. Daha

Published in: Seminars in Immunopathology | Issue 4/2014

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Abstract

IgA nephropathy (IgAN) is the most common diagnosis amongst primary glomerular diseases in most countries where renal biopsies are regularly performed. Only a fraction of these patients is at high risk of losing glomerular filtration rate (GFR) in particular those with high grade proteinuria, uncontrolled hypertension or already impaired GFR at diagnosis, and those with renal scars in the renal biopsy. Genetic modifiers of IgAN onset and/or course are emerging. Spontaneous animal models of IgAN are problematic given considerable species differences between the rodent and human IgA system. However, new transgenic models help to better understand the pathogenesis. A key pathogenetic role appears to be played by underglycated IgA1 as well as autoantibodies to these IgA glycoforms and IgA receptors such as CD89 and transferrin receptor 1. Once IgA and/or IgA-containing immune complexes are deposited or formed in the mesangium, secondary effector mechanisms become important including complement activation, release of mesangial growth factors (in particular platelet-derived growth factor), and finally non-IgAN-specific events that culminate in glomerular and subsequently renal tubulointerstitial scaring. Here, we review these processes and describe potential novel therapeutic targets in IgAN.
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Metadata
Title
New insights into the pathogenesis of IgA nephropathy
Authors
Jürgen Floege
Ivan C. Moura
Mohamed R. Daha
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
Seminars in Immunopathology / Issue 4/2014
Print ISSN: 1863-2297
Electronic ISSN: 1863-2300
DOI
https://doi.org/10.1007/s00281-013-0411-7

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