Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Nephrotic syndrome

Anti-nephrin autoantibodies: a paradigm shift in podocytopathies

A new study demonstrates that anti-nephrin autoantibodies are not merely markers but also actively contribute to the pathogenesis of minimal change disease and primary focal segmental glomerulosclerosis. This insight not only provides a non-invasive diagnostic alternative to kidney biopsies, but also suggests potential for novel targeted therapies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Kidney-specific immune-mediated glomerulonephritis.

References

  1. Iijima, K. et al. Rituximab for childhood-onset, complicated, frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet 384, 1273–1281 (2014).

    Article  CAS  PubMed  Google Scholar 

  2. Watts, A. J. B. et al. Discovery of autoantibodies targeting nephrin in minimal change disease supports a novel autoimmune etiology. J. Am. Soc. Nephrol. 33, 238–252 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Takeuchi, K. et al. New anti-nephrin antibody mediated podocyte injury model using a C57BL/6 mouse strain. Nephron 138, 71–87 (2018).

    Article  CAS  PubMed  Google Scholar 

  4. Hengel, F. E. et al. Autoantibodies targeting nephrin in podocytopathies. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa2314471 (2024).

  5. Zhang, Y. M. et al. Clinical significance of IgM and C3 glomerular deposition in primary focal segmental glomerulosclerosis. Clin. J. Am. Soc. Nephrol. 11, 1582–1589 (2016).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Pedchenko, V. et al. Molecular architecture of the Goodpasture autoantigen in anti-GBM nephritis. N. Engl. J. Med. 363, 343–354 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Uhlin, F. et al. Endopeptidase cleavage of anti-glomerular basement membrane antibodies in vivo in severe kidney disease: an open-label phase 2a study. J. Am. Soc. Nephrol. 33, 829–838 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Beck, L. H. Jr et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N. Engl. J. Med. 361, 11–21 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Fervenza, F. C. et al. Rituximab or cyclosporine in the treatment of membranous nephropathy. N. Engl. J. Med. 381, 36–46 (2019).

    Article  CAS  PubMed  Google Scholar 

  10. Haddad, G. et al. Altered glycosylation of IgG4 promotes lectin complement pathway activation in anti-PLA2R1-associated membranous nephropathy. J. Clin. Invest. 131, e140453 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors thank Huang Kuang for creating the original artwork.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ming-hui Zhao.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cui, Z., Zhao, Mh. Anti-nephrin autoantibodies: a paradigm shift in podocytopathies. Nat Rev Nephrol (2024). https://doi.org/10.1038/s41581-024-00873-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1038/s41581-024-00873-7

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing