目的：微小病变疾病（MCD）和局灶节段肾小球硬化（FSGS）是以肾小球滤过屏障受损为特征的足细胞病变，导致蛋白尿和肾病综合征。已经提出抗足细胞抗体的产生作为促成这些病症发展的潜在循环因子。该研究的目的是评估患有足细胞病的患者和健康受试者中抗nephrin抗体的水平。
方法：在本研究中，共纳入77例活动性肾小球病患者和11例健康受试者.41名患者被诊断为FSGS，11与MCD，25与MN为了测量抗nephrin抗体的水平，采用酶联免疫吸附试验。
结果：MCD61.2[28.9-66.3]ng/mL和FSGS32.5[17.2-58.4]ng/mL患者的nephrin抗体水平明显高于MN20.3[14.4-38.4]和健康个体15.3[12-18.9]ng/mL，p<0.05。在原发性FSGS患者中，与继发性FSGS26.7[11.2-44.1]ng/mL患者相比，nephrin的抗体水平显着高于45.2[20-64.3]ng/mL，p<0.05。抗nephrin抗体阳性和阴性组之间的缓解率没有显着差异（对数秩检验：p=.158）。
结论：发现MCD和pFSGS患者的抗nephrin抗体水平明显高于sFSGS患者，MN,和健康的受试者。MCD和原发性FSGS中的抗nephrin抗体可能与足细胞病变的严重程度有关，然而，它们对治疗的反应没有影响。
OBJECTIVE: Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are podocytopathies characterized by damage to the glomerular filtration barrier, leading to proteinuria and nephrotic syndrome. The production of anti-podocyte antibodies has been proposed as potential circulating factors contributing to the development of these conditions. The aim of the study is to evaluate the levels of anti-nephrin antibodies in patients with podocytopathies and healthy subjects.
METHODS: In this study, a total of 77 patients with active glomerulopathy and 11 healthy subjects were included. Forty one patients were diagnosed with FSGS, 11 with MCD, and 25 with MN. To measure the levels of anti-nephrin antibodies, enzyme-linked immunosorbent assay was used.
RESULTS: The levels of antibodies to nephrin were significantly higher in patients with MCD 61.2 [28.9-66.3] ng/mL and FSGS 32.5 [17.2-58.4] ng/mL compared to MN 20.3 [14.4-38.4] and healthy individuals 15.3 [12-18.9] ng/mL, p < .05. In patients with primary FSGS, the levels of antibodies to nephrin were significantly higher 45.2 [20-64.3] ng/mL compared to patients with secondary FSGS 26.7 [11.2-44.1] ng/mL, p < .05. There were no significant differences in the remission rate between the anti-nephrin antibodies positive and negative groups (log-rank test: p = .158).
CONCLUSIONS: The level of anti-nephrin antibodies was found to be significantly higher in patients with MCD and pFSGS compared to those with sFSGS, MN, and healthy subjects. Anti-nephrin antibodies in MCD and primary FSGS may be associated with the severity of podocytopathies, however they did not have an impact on the response to therapy.
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