Copyright
©The Author(s) 2015.
World J Nephrol. Sep 6, 2015; 4(4): 455-467
Published online Sep 6, 2015. doi: 10.5527/wjn.v4.i4.455
Published online Sep 6, 2015. doi: 10.5527/wjn.v4.i4.455
Genetic locus | Genes | Function |
6q21 | HLA-DRB1, HLADQA1 and HLA-DQB1 | Class II major histocompatibility complex |
PSMB8/9 and TAP/2 | Regulators for antigen processing and presentation | |
1q32 | CFHR1/3 | Modulators for complement activation and inflammation |
22q12 | HORMAD2 | Unknown |
17q13 | TNFSF13 | Important for B cell development and IgA isotype switching |
8p23 | DEFA1 | Encoding a-defensins as a type of endogenous antimicrobial mediators |
1p13 | VAV3 | Regulators for lymphocyte development and antigen presentation |
9q34 | CARD9 | Participant in antigen-induced signalosome formation (CARD9-BCL 10-MALT1) and NF-κB activation |
16p11 | ITGAM and ITGAX | Mediators for immune cell adhesion and phagocytosis |
Hit | Pathogenic process | Putative environmental factors involved | Putative genetic factors involved | Potential clinical biomarkers | Potential novel therapeutic approaches |
1 | Hereditary increase in circulating galactose-deficient IgA1 | Potential role of mucosal exposure to infectious of dietary antigens | Strong evidence for high heritability of serum galactose-deficient IgA1 level Potential role of chromosome 22q12.2 | Serum galactose-deficient IgA1 level (HAA-based ELISA) | Suppression of synthesis of galactose-deficient IgA1 Enzymatic boost of galactose transfer to IgA1 hinge- region O-glycans Suppression of sialylation of galactose-deficient O-glycans |
2 | Circulating antibody directed against galactose-deficient IgA1 | Potential role of mucosal exposure to infectious or dietary antigens | Potential role of three MHC-II loci in antigen presentation and humoral response to galactose-deficient IgA1 O-glycans | Serum anti-glycan antibodies (dot blot assay) | Alteration of processing and presentation of galactose-deficient IgA1 O-glycopeptides Specific B-cell depletion therapy |
3 | Formation of pathogenic IgA1-containing immune complexes | Unknown | Unknown | Circulating and/or urinary immune complexes | Competitive blockade of immune complex formation by non-cross-linking anti-glycan antibodies or specific glycopeptides |
4 | Mesangial deposition of IgA1 containing immune complexes, cell activation and initiation of glomerular injury | Unknown | Protective effect of common deletion in CFHR1 and CFHR3 | Circulating and/or urinary complement degradation products, or novel markers of glomerular injury | Suppression of the alternative complement pathway Targeted CFHR1/3 depletion Blocking mesangial cell signaling induced by nephritogenic IgA1-containing immune complexes |
- Citation: Salvadori M, Rosso G. Update on immunoglobulin A nephropathy, Part I: Pathophysiology. World J Nephrol 2015; 4(4): 455-467
- URL: https://www.wjgnet.com/2220-6124/full/v4/i4/455.htm
- DOI: https://dx.doi.org/10.5527/wjn.v4.i4.455