摘要
本文对近年来原发性膜性肾病(PMN)的发病机制进行了阐述,包括遗传因素、抗原、环境因素、肠道菌群等方面的最新发现,旨在为深入理解PMN的病理生理过程及潜在治疗靶点提供参考依据.在遗传因素方面,研究发现了与PMN的发病风险及预后相关的基因位点,如磷脂酶A2受体(PLA2R)和人类白细胞抗原(HLA).关于PMN抗原,本文主要阐述了PLA2R、抗血小板反应蛋白1型结构域7A(THSD7A)、中性内肽酶(NEP)、PMN新抗原和外源性抗原在膜性肾病诊断及治疗中的作用.此外,环境因素如空气污染、重金属和有机污染物暴露、肠道菌群的变化等也可能与PMN的发病密切相关.综合研究结果为PMN的诊断和治疗提供了新思路.
Abstract
This article reviews the pathogenesis of primary membranous nephropathy(PMN)in recent years,en-compassing the latest findings of genetic,antigenic,environmental factors,and intestinal flora,etc.,so as to pro-vide a reference for further comprehension of the pathophysiological process and potential therapeutic targets as-sociated with PMN.In terms of genetic factors,the study identifies gene loci associated with the risk and progno-sis of PMN,such as phospholipase A2 receptor(PLA2R)and human leukocyte antigen(HLA).Regarding PMN antigens,this paper elaborates on PLA2R,thrombospondin type 1 domain-containing 7A(THSD7A),neutral en-dopeptidase(NEP),PMN neoantigen,and exogenous antigens in the diagnosis and treatment for membranous ne-phropathy.In addition,environmental factors such as air pollution,exposure to heavy metals and organic pollut-ants,and changes in gut microbiota may also be closely related to the incidence of PMN.The findings from this study offer innovative insights for the diagnosis and treatment of PMN.
维普
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