PLA2R1和HLA基因多态性与特发性膜性肾病易感性的研究进展

Research progresson correlation of PLA2R1 and HLA gene polymorphisms with susceptibility toidiopathic membranous nephropathy

膜性肾病(membranous nephropathy,MN)是成人肾病综合征最常见的病理类型之一。发病高峰为40~50岁,男性多于女性,病理特征为肾小球脏层上皮细胞下免疫复合物弥漫性沉积、基底膜增厚伴钉突形成。肾小球疾病最常见的病理类型为IgA肾病,排在其后的为MN,而MN正在以每年13%的速度增长,已有超过IgA肾病的趋势。研究表明约1/3的特发性膜性肾病表现为自发缓解,约1/3表现为持续蛋白尿,约1/3在10年内进入终末期肾病。近年来从遗传学角度研究MN,认为MN的发展与某些基因的多态性位点相关,本文就磷脂酶A2受体(PLA2R1)和人类白细胞抗原(HLA)基因多态性与特发性膜性肾病易感性的研究进展进行综述。

Membranous nephropathy (MN) is one of the most common pathological types of nephrotic syndromes in adults.The incidence peak appearsat the age of 40 to 50 in,more men than women.The pathological features are diffused deposition of immune complexes under the glomerular visceral epithelial cells,thickening of the basement membrane with spike formation.The most common pathological type of glomerular diseases is IgAN,followed by MN,and MN is growing at a rate of 13% per year,which has a tendency to exceed IgAN.Studies have shown that about 1/3 of idiopathic membranous nephropathy(IMN) manifest as spontaneous remission,about one-third of which is characterized by persistent proteinuria,and about one-third of it enters end-stage renal disease (ESRD) within 10 years.In recent years,IMN has been studied from the perspective of genetics,and it is believed that progression of IMN is related to the polymorphic sites of certain genes.In this review,we described research progress on the role of PLA2R1 and HLA gene polymorphisms in susceptibility to idiopathic membranous nephropathy.