IgA肾病的诊治研究进展

Progress in researches on diagnosis and treatment of IgA nephropathy

IgA肾病经过50年的研究取得了不少进展,人们逐步认识到IgA肾病是一种慢性进展性的疾病。粘膜免疫异常,糖基化异常的Ig A1及其抗体的产生以及免疫复合物在肾小球系膜区沉积并激活补体,肾小球的炎症、增殖和硬化,在疾病的发生发展中起着关键的作用。RAS阻断剂具有肾保护作用,但在很多方面还没有定论。本文主要从Ig A肾病生物标志物、病理诊断、免疫抑制治疗和扁桃体摘除等方面,结合最新文献和笔者自己的体会,梳理总结其相关的研究进展,以飨读者。

A lot of progress has been made after 50 years of researches on IgA nephropathy(IgAN).It has been gradually realized that IgAN is a chronic progressive disease,with many factors playing key roles in its development and progression,including mucosal immune abnormalities,abnormal glycosylation of IgA1 and its antibody production,as well as deposition of immune complexes in the glomerular mesangial area,which subsequently activates the complements,promotes the glomerular inflammation,proliferation,and sclerosis.Therapies with renin angiotensin system(RAS)blockers have shown renal protective effects,although there have been no conclusions in many aspects yet.The authors mainly combed through the latest literature and personal clinical experience to summarize the relevant progress of researches on IgAN biomarkers,pathological diagnosis,immunosuppressive therapy,and tonsillectomy,etc,so as to meet the needs of readers.