IgA肾病肾脏纤维化研究进展OA

Immunoglobulin A(IgA)nephropathy(IgAN)initiated by abnormal glycosylated IgA1 im-mune complex deposition in mesangial region,which triggers extracellular matrix remodeling by activating complement and inflammatory reaction,thus forming the fibrosis process of glomerulosclerosis,interstitial fi-brosis and vascular disease.Genetic susceptibility cooperates with mucosal immune imbalance,flora imbalance and metabolic disorder to promote mesangial cell activation and podocyte damage,and build a fibrogenic mi-croenvironment.Tubular atrophy/interstitial fibrosis(T score)in the Oxford classification serves as a critical histological marker for predicting progression to end-stage renal disease.At present,the diagnosis depends on renal biopsy,but non-invasive detection techniques,such as liquid biopsy(MicroRNA,etc.),show potential because of their high specificity and accessibility.The treatment strategy tends to be multi-target combined in-tervention,but it is limited by the lack of biomarker verification and dynamic monitoring means.In the future,it is necessary to break through the bottleneck of accurate typing,integrate omics technology to develop non-invasive markers verified by tissues,build an individualized treatment system based on molecular subtyping and facilitate the full control of the fibrotic process.