07 February 2021 : Review article
A Review of the Current Practice of Diagnosis and Treatment of Idiopathic Membranous Nephropathy in China
Lianzhong Wu12AE, Jin Lai12B, Yixin Ling12C, Yiqin Weng12B, Shujuan Zhou1D, Siqi Wu2D, Songfu Jiang1D, Xiaokai Ding3D, Xin Jin4EFG, Kang Yu1EF*, Yi Chen1EFDOI: 10.12659/MSM.930097
Med Sci Monit 2021; 27:e930097
Background
Research Progress in the Pathogenesis of IMN
Experimental Animal Models
Complement Activation and IMN
New Diagnostic Biomarkers
Genetic Background
Treatment of IMN
Renin-Angiotensin System Inhibitors
Glucocorticoids
Cyclophosphamide
Calcineurin Inhibitors
Adrenocorticotropic Hormone
Rituximab Therapy
Mycophenolate Mofetil
Traditional Chinese Medicine
New Approaches and Remaining Clinical Challenges
Conclusions
References
Table 1 Recent advances and remaining challenges in the diagnosis and treatment of idiopathic membranous nephropathy in China.
| Current advances | Remaining challenges |
|---|---|
| Anti-PLAR detection is used widely | Genetic differences and disease susceptibility |
| THSD7A was identified as a second antigen to facilitate diagnosis | Environmental factors and disease susceptibility |
| EXT1/EXT2 proteins may represent biomarkers for MN associated with autoimmune disease | The physiological roles of PLAR and THSD7A |
| Progress related to the complement system | The mechanisms of podocyte injury induced by IgG4 anti-PLAR and anti-THSD7A |
| Rituximab therapy | Defining the pathogenicity of complement and CRPs |
| CRPs – complement and complement regulatory proteins; EXT1/EXT2 – exostosin1/exostosin2; MN – membranous nephropathy; PLAR – phospholipase A receptor; THSD7A – thrombospondin type-1 domain-containing 7A. | |