Taking the kidney personally: The quest for novel antigens of idiopathic membranous nephropathy through proteomic approaches - per ardua ad astra?

摘要

Membranous nephropathy is one of the most common diseases affecting the glomerulus, an important part of the kidney responsible for filtration of blood. Glomeruli are networks of capillaries that filter blood; normally only small ions and proteins are filtered, while larger proteins like hemoglobin, albumin, and immunoglobulins are retained. The filtration barrier consists of several layers including: capillary endothelial cells, glomerular basement membrane, and specialized cells called podocytes. In patients with membranous nephropathy, this selective barrier is injured, leading to massive loss of proteins in urine (proteinuria). Patients typically present with marked swelling due to protein loss and avid sodium absorption by the kidneys, as well as hypoalbuminemia, hyperlipidemia, lipiduria, and propensity for developing infections and clots (called nephrotic syndrome).