The Role of IgA in the Pathogenesis of IgA Nephropathy

Perše, Martina; Večerić-Haler, Željka

doi:10.3390/ijms20246199

Cited by 62 publications

(38 citation statements)

References 74 publications

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“…Another possibility is that of an enhanced mucosal IgA1 response that leads to a “spillover” of Gd-IgA1 into the circulation ( Magistroni et al, 2015 ). Therefore, given the ineffectiveness of rituximab, mucosal-associated lymphoid tissues, the inductive sites of the originating B-cells, may be considered candidate tissues of Gd-IgA1 production, especially the Peyer’s patches, isolated lymphoid follicles and tonsils ( Xie et al, 2004 ; Perše and Večerić-Haler, 2019 ). Notably, another randomized, controlled, single-blind study (NCT04525729) on rituximab in treating primary IgAN is now recruiting participants in China, and the results are expected in 2023.…”

Section: Regulation Of Immune Response In Iganmentioning

confidence: 99%

An Update on Targeted Treatment of IgA Nephropathy: An Autoimmune Perspective

Huang

2021

Front. Pharmacol.

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Immunoglobulin (Ig) A nephropathy (IgAN) is the commonest form of primary glomerulonephritis worldwide and is, considered a significant cause of end-stage renal disease in young adults. The precise pathogenesis of IgAN is unclear. The clinical and pathological features vary significantly between individuals and races, which makes treating IgAN difficult. Currently, the therapeutic strategies in IgAN are still optimal blood pressure control and proteinuria remission to improve the renal function in most cases. Immunosuppressive drugs such as corticosteroids can be considered in patients with persistent proteinuria and a high risk of renal function decline; however, they include a high toxicity profile. Therefore, the safety and selectivity of medications are critical concerns in the treatment of IgAN. Various pharmacological therapeutic targets have emerged based on the evolving understanding of the autoimmune pathogenesis of IgAN, which involves the immune response, mucosal immunity, renal inflammation, complement activation, and autophagy; treatments based on these mechanisms have been explored in preclinical and clinical studies. This review summarizes the progress concerning targeted therapeutic strategies and the relevant autoimmune pathogenesis in IgAN.

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Section: Regulation Of Immune Response In Iganmentioning

confidence: 99%

An Update on Targeted Treatment of IgA Nephropathy: An Autoimmune Perspective

Huang

2021

Front. Pharmacol.

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“…In serum, IgA is mainly monomeric, belonging to the IgA1 subclass with rapid catabolism (half-life: 3-6 d) 14 . Moreover, IgA is the most glycosylated form of immunoglobulins, with carbohydrates representing about 6% of its content 15 . Unlike IgA2, the heavy chains of IgA1 molecules are known to contain a unique insertion in the hinge-region segment with a high content of serine and threonine residues.…”

Section: Immunoglobulin a (Iga)mentioning

confidence: 99%

Perspectives on how mucosal immune responses, infections and gut microbiome shape IgA nephropathy and future therapies

He¹,

Zhou²,

Lv³

et al. 2020

Theranostics

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Infections have been considered to play a critical role in the pathogenesis of IgA nephropathy (IgAN) because synpharyngitic hematuria is a common feature in IgAN. However, how infections participate in this process is still debated. More recent studies have also revealed that the alteration of the gut microbiome exerts a profound effect on host immune responses, contributing to the etiology or progression of autoimmunity. Considering IgA as the first line of defense against bacterial and viral antigens, this review evaluates the relationships among intestinal infections, gut microbiome, and IgA for a better understanding of the pathogenesis of IgAN. Moreover, as a prototype of IgA immunity, we provide detailed clarification of IgAN pathogenesis to shed light on other diseases in which IgA plays a role. Finally, we discuss potential therapies focusing on microbes and mucosal immune responses in IgAN.

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“…Immunoglobulin A nephropathy (lgAN) is a common glomerulonephritis, which is characterized by glomerular immune deposits comprising primarily of IgA. 1 Paraneoplastic glomerular disease was first reported in 1966 and the incidence rate is approximately 10.9%. 2 The most common neoplasms associated with paraneoplastic glomerular disease are carcinomas of the lung and gastrointestinal tract.…”

Section: Introductionmentioning

confidence: 99%

Paraneoplastic immunoglobulin A nephropathy in a patient with lung adenocarcinoma: A case report and literature review

et al. 2021

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Immunoglobulin A nephropathy (lgAN) is a common primary glomerulonephritis, but paraneoplastic IgAN has been rarely reported. This current case report describes a 49-year-old male patient that was referred with proteinuria, oedema and hypoproteinaemia after lung cancer surgery and before the first cycle of chemotherapy. Renal biopsy confirmed lgAN. The patient received four cycles of chemotherapy (first cycle: pemetrexed + nedaplatin; second to fourth cycle: pemetrexed + carboplatin). The symptoms of IgAN were gradually relieved with additional cycles of chemotherapy. At the latest follow-up on 10 February 2020, there was no evidence of lung cancer recurrence and all symptoms of lgAN had disappeared. lgAN combined with lung adenocarcinoma is quite rare, which suggests that IgAN might be a paraneoplastic manifestation of lung adenocarcinoma.

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The Role of IgA in the Pathogenesis of IgA Nephropathy

Cited by 62 publications

References 74 publications

An Update on Targeted Treatment of IgA Nephropathy: An Autoimmune Perspective

An Update on Targeted Treatment of IgA Nephropathy: An Autoimmune Perspective

Perspectives on how mucosal immune responses, infections and gut microbiome shape IgA nephropathy and future therapies

Paraneoplastic immunoglobulin A nephropathy in a patient with lung adenocarcinoma: A case report and literature review

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