1型血小板反应蛋白7A域在膜性肾病中的研究进展

摘要

在PLA2R1及其抗体研究的基础上,1型血小板7A域及其抗体的发现使人们对膜性肾病又有了新的认识.THSD7A是在PLA2R1阴性的膜性肾病患者中发现的,故有部分研究报道提出PLA2R1与THSD7A的自身抗体在膜性肾病中相互排斥,但最新研究表明,THSD7A可与PLA2R1在膜性肾病患者中共存,呈现双阳性.与PLA2R1类似,THSD7A对膜性肾病具有指导诊断、治疗、监测等意义.与PLA2R1不同的是,THSD7A在人类和啮齿类动物的肾小球中均高度表达,故未来可利用小鼠模型研究THSD7A相关性膜性肾病的发病机制.文章就THSD7A及其抗体的结构、作用、与膜性肾病之间的关系及应用前景的研究进展进行综述.%After the research of PLA2R1 and its antibodies, Thrombospondin type-1 domain-containing 7A and its antibodies to membranous nephropathy (MN) has made a new understanding.Some researches have reported that the antibodies of PLA2R1 and THSD7A were mutually exclusive in MN, because THSD7A was found in PLA2R1-negative MN patients.But the latest researcher showed that these antibodies can be both positive in MN patients.Similar to the function of PLA2R1, THSD7A can assist clinical diagnosis, treatment, and monitor of MN.In contrast to PLA2R1, THSD7A was also highly expressed on both human and murine podocytes.We can use the mice model to study the pathogenesis of THSD7A-associated MN in the future.In this review, we describe the structure and function of Thrombospondin type-1 domain-containing 7A and its autoantibodies, highlight its role in MN and suggest possible aspects of its future clinical application.