Lecture Code : GL01-S2
Session Name : Glomerulonephritis
Session Topic : Glomerulonephritis
Date & Time, Place : June 12 (Fri) / 10:20-12:00 / Room 1 (GBR 101), 1F
Novel Antigens in Membranous Nephropathy: From Discovery to Clinical Integration
Yaerim Kim
Keimyung University Dongsan Medical Center, Republic of Korea
Membranous nephropathy (MN) has undergone a major paradigm shift over the past decade, evolving from a morphologically defined disease into an antigen-based autoimmune glomerular disorder. Since the identification of phospholipase A2 receptor (PLA2R) as the major target antigen in primary MN, multiple additional antigens including THSD7A, NELL1, EXT1/EXT2, SEMA3B, PCDH7, NCAM1, HTRA1, FAT1, and others have been discovered through advances in laser microdissection, mass spectrometry, and tissue proteomics. These discoveries have substantially improved our understanding of disease heterogeneity, pathogenic mechanisms, and clinicopathologic phenotypes in MN.
The expanding antigenic landscape has important clinical implications. Distinct antigens are increasingly associated with specific demographic characteristics, underlying conditions, histopathologic patterns, and prognostic profiles. For example, NELL1-associated MN has been linked to malignancy and drug exposure, EXT1/EXT2 positivity is enriched in autoimmune disease associated MN, and SEMA3B is more frequently observed in pediatric disease. Antigen identification has therefore become an essential component of precision diagnosis and risk stratification in MN.
In parallel, antigen-based diagnostics are being progressively integrated into clinical practice. Tissue-based immunohistochemistry and circulating autoantibody assays now support noninvasive diagnosis, disease monitoring, assessment of immunologic remission, and therapeutic decision-making. Furthermore, the recognition of antigen-specific disease subsets is creating opportunities for biomarker-driven clinical trials and targeted therapeutic approaches.
This lecture will review the historical evolution of antigen discovery in MN, summarize the clinicopathologic characteristics of recently identified antigens, and discuss how these advances are reshaping diagnostic algorithms and clinical management. Finally, future directions and remaining challenges for translating antigen discovery into precision medicine for MN will be highlighted.
Keywords: Membranous Nephropaghy, Novel , Antigen