Terapevticheskii arkhiv

Терапевтический архив

0040-36602309-5342

LLC Obyedinennaya Redaktsiya

32024

Editorial article

Передовая статья

Review Article

Idiopathic membranous nephropathy: Evolution in understanding the problem

Идиопатическая мембранозная нефропатия: эволюция в понимании проблемы

Bobkova

I N

Бобкова

И Н

Kakhsurueva

P A

Кахсуруева

П А

Stavrovskaya

E V

Ставровская

Е В

Первый МГМУ им. И.М. Сеченова Минздрава России

15062016

886

VOL 88, NO6 ()

ТОМ 88, №6 (2016)

899410042020

2016

Consilium Medicum

ООО "Консилиум Медикум"

https://creativecommons.org/licenses/by-nc-sa/4.0

https://ter-arkhiv.ru/0040-3660/article/view/32024

The review highlights the evolution of ideas on the mechanisms responsible for the development of membranous nephropathy (MN), glomerulopathy that is the most common cause of nephrotic syndrome in adults. Primary emphasis is placed on the primary form of MN. The important step to understanding the nature of this clinical and morphological form of glomerulonephritis is to create its animal model (Heymann nephritis), then to decipher the mechanisms of immune complex damage (complement activation, a role of cellular immunity), and to identify autoantigens responsible for the development of idiopathic MN in man (podocyte neutral endopeptidase, transmembrane M-type phospholipase A2 receptor, thrombospondin type-1 domain-containing 7A. The findings constituted the basis for developing current methods for the diagnosis and treatment of MN, including the pathogenetically sound inhibition of autoantibody production, as well as a molecular orientation effect on podocyte dysfunction.

Аннотация В обзоре освещена эволюция представлений о механизмах развития мембранозной нефропатии (МН) — гломерулопатии, являющейся наиболее частой причиной нефротического синдрома у взрослых. Основное внимание уделено первичной форме МН. Важным этапом на пути к пониманию природы данной клинико-морфологической формы гломерулонефрита стало создание его животной модели (хеймановский нефрит), а в последующем — расшифровка механизмов иммунокомплексного повреждения (активация комплемента, роль клеточного звена иммунитета) и идентификация аутоантигенов, ответственных за развитие идиопатической МН у человека (подоцитарная нейтральная эндопептидаза — NEP, трансмембранный М-типа рецептор фосфолипазы А2 — PLA2R, домен тромбоспондина 1-го типа, содержащий 7А, — THSD7A). Полученные данные легли в основу создания современных методов диагностики и лечения МН, включая патогенетически обоснованное подавление выработки аутоантител, а также молекулярно направленное действие на дисфункцию подоцитов.

membranous nephropathyHeymann nephritispodocyte neutral endopeptidasetransmembrane M-type phospholipase A2 receptorthrombospondin type-1 domain-containing 7A

мембранозная нефропатияхеймановский нефритподоцитарная нейтральная эндопептидазатрансмембранный М-типа рецептор фосфолипазы А2домен тромбоспондина 1-го типасодержащий 7А

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