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已发表论文
从活动性病变和系统性炎症反应视角看 IgA 肾病的新见解
Received 30 November 2025
Accepted for publication 28 March 2026
Published 21 April 2026 Volume 2026:15 585437
DOI https://doi.org/10.2147/ITT.S585437
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Flavio Salazar-Onfray
Yang Yang, Gaosi Xu
Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China
Correspondence: Gaosi Xu, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, People’s Republic of China, Tel/Fax +86 791 86312770, Email gaosixu@163.com
Abstract: Immunoglobulin A nephropathy (IgAN) is a chronic disease. Active disease typically presents with massive proteinuria and gross hematuria, along with renal pathological features such as mesangial cell proliferation, endothelial cell proliferation, and crescents. Active lesions may achieve remission following treatment but also can relapse at any stage of the patient’s life. Systemic inflammatory markers are significantly associated with IgAN disease activity indicators. Research has found that patients with high disease activity and low chronicity are more likely to benefit from immunosuppressive therapy. We speculated that “four-hit” hypothesis in IgAN may exist as the background for the recurrence of the disease. Bacterial or viral infections and vaccinations are common mucosal triggers that may induce active lesions by activating systemic inflammatory responses. The clinical manifestations triggered by these factors are diverse, which likely reflects the complex interplay between the nature of the injury and individual patient susceptibility. In this narrative review, we explore new insight on IgAN from the perspective of active disease and systemic inflammatory responses.
Keywords: IgA nephropathy, MEST-C classification, active lesion, systemic inflammation, innate immunity
Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China
Correspondence: Gaosi Xu, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, People’s Republic of China, Tel/Fax +86 791 86312770, Email gaosixu@163.com
Abstract: Immunoglobulin A nephropathy (IgAN) is a chronic disease. Active disease typically presents with massive proteinuria and gross hematuria, along with renal pathological features such as mesangial cell proliferation, endothelial cell proliferation, and crescents. Active lesions may achieve remission following treatment but also can relapse at any stage of the patient’s life. Systemic inflammatory markers are significantly associated with IgAN disease activity indicators. Research has found that patients with high disease activity and low chronicity are more likely to benefit from immunosuppressive therapy. We speculated that “four-hit” hypothesis in IgAN may exist as the background for the recurrence of the disease. Bacterial or viral infections and vaccinations are common mucosal triggers that may induce active lesions by activating systemic inflammatory responses. The clinical manifestations triggered by these factors are diverse, which likely reflects the complex interplay between the nature of the injury and individual patient susceptibility. In this narrative review, we explore new insight on IgAN from the perspective of active disease and systemic inflammatory responses.
Keywords: IgA nephropathy, MEST-C classification, active lesion, systemic inflammation, innate immunity