New Insights into the Pathogenesis of IgA Nephropathy

Background: IgA nephropathy, a frequent cause of endstage renal disease, is an autoimmune disease wherein immune complexes consisting of IgA1 with galactose-deficient O -glycans (autoantigen) and anti-glycan autoantibodies deposit in glomeruli and induce renal injury. Multiple genetic loci associated with disease risk have been identified. The prevalence of risk alleles varies geographically: it is the highest in eastern Asia and northern Europe, lower in other parts of Europe and North America, and the lowest in Africa. IgA nephropathy is diagnosed by the pathological assessment of a renal biopsy specimen. Currently, therapy is not disease targeted but rather focused on maintaining control of blood pressure and proteinuria, ideally with suppression of angiotensin II. Possible additional approaches differ between countries. Disease-specific therapy as well as new tools for the diagnosis, prognosis, and assessment of responses to Received: March 20, 2015 Accepted after revision: April 9, 2015 Published online: May 1, 2015 Dr. Jan Novak Department of Microbiology, University of Alabama at Birmingham 845 19th Street South, BBRB 761A (Box 1) Birmingham, AL 35294 (USA) E-Mail jannovak @ uab.edu © 2015 S. Karger AG, Basel 2296–9381/15/0011–0008$39.50/0