{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:36:31Z","timestamp":1773099391466,"version":"3.50.1"},"reference-count":128,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Primary membranous nephropathy (PMN) is a major cause of adult nephrotic syndrome and demonstrates considerable clinical heterogeneity. This review summarizes current evidence on the immunological mechanisms and clinical predictors underlying spontaneous remission (SR) in PMN. We discuss key factors including the dynamics of anti-PLA2R antibodies, proteinuria trends, renal function indicators, histopathological features, and emerging biomarkers. A staged immune modulation process is proposed, involving suppression of autoreactive responses and promotion of tissue repair. Integrating these insights, we also outline a personalized treatment approach based on dynamic risk stratification and longitudinal monitoring. Understanding the drivers of SR may help reduce unnecessary immunosuppression and guide precision management in PMN.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1651810","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T05:26:18Z","timestamp":1757568378000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Spontaneous remission in primary membranous nephropathy: mechanisms, predictive factors, and implications for personalized management"],"prefix":"10.3389","volume":"16","author":[{"given":"Mengqi","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zixin","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youping","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"B1","article-title":"Membranous Nephropathy. Statpearls. Treasure Island (FL) ineligible companies","volume-title":"Disclosure: Anju Yadav declares no relevant financial relationships with ineligible companies.: StatPearls Publishing Copyright","author":"Alok","year":"2025"},{"key":"B2","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1038\/s41572-021-00303-z","article-title":"Membranous nephropathy","volume":"7","author":"Ronco","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"B3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1136\/postgradmedj-2018-135729","article-title":"Primary membranous nephropathy: comprehensive review and historical perspective","volume":"95","author":"Keri","year":"2019","journal-title":"Postgraduate Med J"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.593288","article-title":"Autoantibodies in the diagnosis, monitoring, and treatment of membranous nephropathy","volume":"12","author":"Tesar","year":"2021","journal-title":"Front Immunol"},{"key":"B5","article-title":"Epidemiology of primary glomerulonephritis in the elderly","volume":"14","author":"Vendemia","year":"2001","journal-title":"Rep Ital Registry Renal Biopsy. J Nephrol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1159\/000484717","article-title":"Changes in the spectrum of kidney diseases: an analysis of 40,759 biopsy-proven cases from 2003 to 2014 in China","volume":"4","author":"Hou","year":"2018","journal-title":"Kidney Dis (Basel Switzerland)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.11761116","article-title":"Primary membranous nephropathy","volume":"12","author":"Couser","year":"2017","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1056\/NEJMoa0810457","article-title":"M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy","volume":"361","author":"Beck","year":"2009","journal-title":"New Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1172\/jci85265","article-title":"Autoantibodies against thrombospondin type 1 domain-containing 7a induce membranous nephropathy","volume":"126","author":"Tomas","year":"2016","journal-title":"J Clin Invest"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.01460217","article-title":"Circulating antibodies against thrombospondin type-I domain-containing 7a in chinese patients with idiopathic membranous nephropathy","volume":"12","author":"Wang","year":"2017","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.907108","article-title":"Recent advances in clinical diagnosis and pharmacotherapy options of membranous nephropathy","volume":"13","author":"Wang","year":"2022","journal-title":"Front Pharmacol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1681\/asn.2009080861","article-title":"Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy","volume":"21","author":"Polanco","year":"2010","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/mco2.614","article-title":"Membranous nephropathy: pathogenesis and treatments","volume":"5","author":"Wang","year":"2024","journal-title":"MedComm"},{"key":"B14","doi-asserted-by":"publisher","first-page":"Cd004293","DOI":"10.1002\/14651858.CD004293.pub4","article-title":"Immunosuppressive treatment for primary membranous nephropathy in adults with nephrotic syndrome","volume":"11","author":"von Groote","year":"2021","journal-title":"Cochrane Database systematic Rev"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-022-01493-9","article-title":"From Kdigo 2012 Towards Kdigo 2021 in Idiopathic Membranous Nephropathy Guidelines: What Has Changed over the Last 10 years","volume":"36","author":"Stai","year":"2023","journal-title":"J Nephrol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2016040449","article-title":"Rituximab for severe membranous nephropathy: A 6-month trial with extended follow-up","volume":"28","author":"Dahan","year":"2017","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.859419","article-title":"Advances in the management of primary membranous nephropathy and rituximab-refractory membranous nephropathy","volume":"13","author":"Teisseyre","year":"2022","journal-title":"Front Immunol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2021.05.021","article-title":"Clinical practice guideline for the management of glomerular diseases","volume":"100","year":"2021","journal-title":"Kidney Int (2021)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1681\/ASN.20233411S1286c","article-title":"I am the lucky third: spontaneous resolution of high-risk membranous nephropathy","volume":"34","author":"Bin Homam","year":"2023","journal-title":". J Am Soc Nephrol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1007\/s00424-017-2007-x","article-title":"A podocyte view of membranous nephropathy: from heymann nephritis to the childhood human disease","volume":"469","author":"Ronco","year":"2017","journal-title":"Pflugers Archiv: Eur J Physiol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.969930","article-title":"Membranous nephropathy: systems biology-based novel mechanism and traditional chinese medicine therapy","volume":"13","author":"Miao","year":"2022","journal-title":"Front Pharmacol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2017010030","article-title":"A heterologous model of thrombospondin type 1 domain-containing 7a-associated membranous nephropathy","volume":"28","author":"Tomas","year":"2017","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.01.012","article-title":"B- and T-cell subpopulations in patients with severe idiopathic membranous nephropathy may predict an early response to rituximab","volume":"92","author":"Rosenzwajg","year":"2017","journal-title":"Kidney Int"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1159\/000529415","article-title":"Phospholipase A2 receptor antibodies and clinical prognosis in patients with idiopathic membranous nephropathy: an updated systematic review and meta-analysis","volume":"48","author":"Zhang","year":"2023","journal-title":"Kidney Blood Pressure Res"},{"key":"B25","first-page":"S1","article-title":"Renal lesion in Iraqi body builders \u2013 a case series","volume-title":"ISN world congress of nephrology; 2020\/03\/26-2020\/03\/29; abu dhabi, United Arab Emirates: kidney international reports","author":"Ali","year":"2020"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.07.028","article-title":"A comprehensive phenotypic and functional immune analysis unravels circulating anti-phospholipase A2 receptor antibody secreting cells in membranous nephropathy patients","volume":"5","author":"Cantarelli","year":"2020","journal-title":"Kidney Int Rep"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.03.023","article-title":"Regulatory B cells are reduced and correlate with disease activity in primary membranous nephropathy","volume":"5","author":"Ramachandran","year":"2020","journal-title":"Kidney Int Rep"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.5414\/cn110333","article-title":"Changes and significance of treg and th17 in adult patients with primary membranous nephropathy","volume":"96","author":"Ma","year":"2021","journal-title":"Clin Nephrol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/0008-8749(86)90264-9","article-title":"Reestablishment of self tolerance by suppressor T-cells after active heymann\u2019s nephritis","volume":"98","author":"de Heer","year":"1986","journal-title":"Cell Immunol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2011090914","article-title":"Cd8+ Regulatory T cells induced by T cell vaccination protect against autoimmune nephritis","volume":"23","author":"Wang","year":"2012","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e70005","DOI":"10.1111\/nep.70005","article-title":"Cd8(+) regulatory T cells induced by peptide vaccination ameliorates experimental model of membranous nephropathy","volume":"30","author":"Chung","year":"2025","journal-title":"Nephrol (Carlton Vic)"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1126\/science.abi9591","article-title":"Kir(+)Cd8(+) T cells suppress pathogenic T cells and are active in autoimmune diseases and covid-19","volume":"376","author":"Li","year":"2022","journal-title":"Sci (New York NY) (2022)"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s13730-023-00780-z","article-title":"Complete remission of primary membranous nephropathy following hepatitis E infection","volume":"12","author":"Takanohashi","year":"2023","journal-title":"CEN Case Rep"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-013-0628-3","article-title":"Dramatic remission of nephrotic syndrome after unusual complication of mucormycosis in idiopathic membranous nephropathy","volume":"46","author":"Ye","year":"2014","journal-title":"Int Urol Nephrol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"99","DOI":"10.5414\/cnp68099","article-title":"Remission of nephrotic membranous glomerulonephritis after high-dose trimethoprim-sulfamethoxazole treatment for pneumocystis jiroveci pneumonia","volume":"68","author":"Wen","year":"2007","journal-title":"Clin Nephrol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1458209","article-title":"Pd-1 immunology in the kidneys: A growing relationship","volume":"15","author":"Chen","year":"2024","journal-title":"Front Immunol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.03850414","article-title":"M-type phospholipase A2 receptor autoantibodies and renal function in patients with primary membranous nephropathy","volume":"9","author":"Hoxha","year":"2014","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2013040430","article-title":"Phospholipase A2 receptor autoantibodies and clinical outcome in patients with primary membranous nephropathy","volume":"25","author":"Hoxha","year":"2014","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab116","article-title":"Monitoring anti-pla2r antibody titres to predict the likelihood of spontaneous remission of membranous nephropathy","volume":"14","author":"Jatem-Escalante","year":"2021","journal-title":"Clin Kidney J"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1159\/000445361","article-title":"Serum anti-pla2r antibody predicts treatment outcome in idiopathic membranous nephropathy","volume":"43","author":"Wei","year":"2016","journal-title":"Am J Nephrol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2017070734","article-title":"Phospholipase A2 receptor 1 epitope spreading at baseline predicts reduced likelihood of remission of membranous nephropathy","volume":"29","author":"Seitz-Polski","year":"2018","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.12.035","article-title":"Rituximab in membranous nephropathy","volume":"6","author":"Gauckler","year":"2021","journal-title":"Kidney Int Rep"},{"key":"B43","doi-asserted-by":"publisher","first-page":"s","DOI":"10.1371\/journal.pone.0110681","article-title":"Pla2r antibody levels and clinical outcome in patients with membranous nephropathy and non-nephrotic range proteinuria under treatment with inhibitors of the renin-angiotensin system","volume":"9","author":"Hoxha","year":"2014","journal-title":"PloS One"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.10.004","article-title":"Clinical usefulness of autoantibodies to M-type phospholipase A2 receptor (Pla2r) for monitoring disease activity in idiopathic membranous nephropathy (Imn)","volume":"15","author":"Radice","year":"2016","journal-title":"Autoimmun Rev"},{"key":"B45","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1002\/phar.1575","article-title":"Overview of current and alternative therapies for idiopathic membranous nephropathy","volume":"35","author":"Tran","year":"2015","journal-title":"Pharmacotherapy"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2016.1225497","article-title":"Pharmacological treatment of primary membranous nephropathy in 2016","volume":"9","author":"van de Logt","year":"2016","journal-title":"Expert Rev Clin Pharmacol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409354","article-title":"Thrombospondin type-1 domain-containing 7a in idiopathic membranous nephropathy","volume":"371","author":"Tomas","year":"2014","journal-title":"New Engl J Med"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1511702","article-title":"A mechanism for cancer-associated membranous nephropathy","volume":"374","author":"Hoxha","year":"2016","journal-title":"New Engl J Med"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fneph.2024.1323432","article-title":"Nell1 membranous nephropathy: clinical associations provide mechanistic clues","volume":"4","author":"Andeen","year":"2024","journal-title":"Front Nephrol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v11.i4.115","article-title":"New antigens involved in membranous nephropathy beyond phospholipase A2 receptor","volume":"11","author":"Salvadori","year":"2022","journal-title":"World J Nephrol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2020081165","article-title":"Protocadherin 7-associated membranous nephropathy","volume":"32","author":"Sethi","year":"2021","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.11.028","article-title":"A target antigen-based approach to the classification of membranous nephropathy","volume":"96","author":"Bobart","year":"2021","journal-title":"Mayo Clinic Proc"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1368457","article-title":"Specific antigens in Malignancy-associated membranous nephropathy","volume":"11","author":"Hu","year":"2024","journal-title":"Front Med"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.07.006","article-title":"Ajkd atlas of renal pathology: membranous nephropathy","volume":"66","author":"Fogo","year":"2015","journal-title":"Am J Kidney diseases: Off J Natl Kidney Foundation"},{"key":"B55","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.3390\/cells9071700","article-title":"Regulation of the actin cytoskeleton in podocytes","volume":"9","author":"Blaine","year":"2020","journal-title":"Cells"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.90606.2008","article-title":"Acute hypertension provokes acute trafficking of distal tubule na-cl cotransporter (Ncc) to subapical cytoplasmic vesicles","volume":"296","author":"Lee","year":"2009","journal-title":"Am J Physiol Renal Physiol"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(15)60731-0","article-title":"Pathophysiological advances in membranous nephropathy: time for a shift in patient\u2019s care","volume":"385","author":"Ronco","year":"2015","journal-title":"Lancet (London England)"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.10.009","article-title":"Membranous nephropathy: core curriculum 2021","volume":"77","author":"Alsharhan","year":"2021","journal-title":"Am J Kidney diseases: Off J Natl Kidney Foundation"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/s0272-6386(99)70138-1","article-title":"Prognosis after a complete remission in adult patients with idiopathic membranous nephropathy","volume":"33","author":"Laluck","year":"1999","journal-title":"Am J Kidney diseases: Off J Natl Kidney Foundation"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00873.x","article-title":"Idiopathic membranous nephropathy: definition and relevance of a partial remission","volume":"66","author":"Troyanov","year":"2004","journal-title":"Kidney Int"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2018.1487864","article-title":"Urinary protein and renal prognosis in idiopathic membranous nephropathy: A multicenter retrospective cohort study in Japan","volume":"40","author":"Yamaguchi","year":"2018","journal-title":"Renal failure"},{"key":"B62","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12882-017-0525-6","article-title":"Factors affecting the long-term outcomes of idiopathic membranous nephropathy","volume":"18","author":"Huh","year":"2017","journal-title":"BMC Nephrol"},{"key":"B63","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1681\/asn.2015111262","article-title":"Membranous nephropathy: quantifying remission duration on outcome","volume":"28","author":"Cattran","year":"2017","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.61918","article-title":"The association of lower levels of baseline proteinuria with earlier remission in primary membranous nephropathy","volume":"16","author":"Joseph","year":"2024","journal-title":"Cureus"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002201","article-title":"Membranous nephropathy: when and how to treat","volume":"71","author":"Lai","year":"2007","journal-title":"Kidney Int"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1681\/asn.V84664","article-title":"Membranous glomerulonephritis","volume":"8","author":"Wasserstein","year":"1997","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B67","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1093\/ckj\/sfy005","article-title":"Antiphospholipase 2 receptor antibody levels to predict complete spontaneous remission in primary membranous nephropathy","volume":"12","author":"Rodas","year":"2019","journal-title":"Clin Kidney J"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-020-02588-7","article-title":"The association of anti-pla2r with clinical manifestations and outcomes in idiopathic membranous nephropathy: A meta-analysis","volume":"52","author":"Rao","year":"2020","journal-title":"Int Urol Nephrol"},{"key":"B69","doi-asserted-by":"publisher","first-page":"9051","DOI":"10.3390\/ijms24109051","article-title":"The prognostic value of anti-pla2r antibodies levels in primary membranous nephropathy","volume":"24","author":"Kukuy","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2014111061","article-title":"Epitope spreading of autoantibody response to pla2r associates with poor prognosis in membranous nephropathy","volume":"27","author":"Seitz-Polski","year":"2016","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2012030242","article-title":"Antiphospholipase A2 receptor antibody titer and subclass in idiopathic membranous nephropathy","volume":"23","author":"Hofstra","year":"2012","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1159\/000437236","article-title":"Anti-pla2r antibodies as a prognostic factor in pla2r-related membranous nephropathy","volume":"42","author":"Timmermans","year":"2015","journal-title":"Am J Nephrol"},{"key":"B73","doi-asserted-by":"publisher","first-page":"2624","DOI":"10.3390\/jcm10122624","article-title":"Clinical phenotypes and predictors of remission in primary membranous nephropathy","volume":"10","author":"Jurubi","year":"2021","journal-title":"J Clin Med"},{"key":"B74","doi-asserted-by":"publisher","first-page":"e62151","DOI":"10.1371\/journal.pone.0062151","article-title":"Autoantibodies against phospholipase A2 receptor in korean patients with membranous nephropathy","volume":"8","author":"Oh","year":"2013","journal-title":"PloS One"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13133","article-title":"Anti-phospholipase a2 Receptor antibodies in recurrent membranous nephropathy","volume":"15","author":"Kattah","year":"2015","journal-title":"Am J transplantation: Off J Am Soc Transplant Am Soc Transplant Surgeons"},{"key":"B76","doi-asserted-by":"publisher","first-page":"1990","DOI":"10.1097\/tp.0000000000002758","article-title":"Membranous nephropathy posttransplantation: an update of the pathophysiology and management","volume":"103","author":"Leon","year":"2019","journal-title":"Transplantation"},{"key":"B77","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1681\/asn.2019030273","article-title":"Clinical relevance of domain-specific phospholipase a(2) receptor 1 antibody levels in patients with membranous nephropathy","volume":"31","author":"Reinhard","year":"2020","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2023.2194451","article-title":"Acute kidney injury in patients with idiopathic membranous nephropathy: influencing factors and prognosis","volume":"45","author":"Li","year":"2023","journal-title":"Renal failure"},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2023.2205951","article-title":"Clinical characteristics and prognosis of patients with idiopathic membranous nephropathy with kidney tubulointerstitial damage","volume":"45","author":"Sun","year":"2023","journal-title":"Renal failure"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2023.2212081","article-title":"Clinicopathological features and outcome in elderly patients with idiopathic membranous nephropathy","volume":"45","author":"Liang","year":"2023","journal-title":"Renal failure"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.1111\/his.13955","article-title":"Histological grading in primary membranous nephropathy is essential for clinical management and predicts outcome of patients","volume":"75","author":"Stangou","year":"2019","journal-title":"Histopathology"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.3892\/br.2015.555","article-title":"Analysis of the prognostic risk factors of idiopathic membranous nephropathy using a new surrogate end-point","volume":"4","author":"Zhang","year":"2016","journal-title":"Biomed Rep"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.048","article-title":"Membranous nephropathy: integrating basic science into improved clinical management","volume":"91","author":"Cattran","year":"2017","journal-title":"Kidney Int"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12478","article-title":"Antibodies to M-type phospholipase A2 receptor in children with idiopathic membranous nephropathy","volume":"20","author":"Kumar","year":"2015","journal-title":"Nephrol (Carlton Vic)"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2016070776","article-title":"A proposal for a serology-based approach to membranous nephropathy","volume":"28","author":"De Vriese","year":"2017","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfy079","article-title":"Anti-phospholipase A2 receptor antibody and spontaneous remission in membranous nephropathy","volume":"12","author":"Diaz","year":"2019","journal-title":"Clin Kidney J"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.1159\/000513869","article-title":"Association of obesity with cardiovascular risk factors and kidney disease outcomes in primary proteinuric glomerulopathies","volume":"145","author":"Shah","year":"2021","journal-title":"Nephron"},{"key":"B88","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ckj\/sfw139","article-title":"Obesity and kidney disease: hidden consequences of the epidemic","volume":"10","author":"Kovesdy","year":"2017","journal-title":"Clin Kidney J"},{"key":"B89","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.semnephrol.2012.12.006","article-title":"Obesity and kidney disease: potential mechanisms","volume":"33","author":"Wickman","year":"2013","journal-title":"Semin Nephrol"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.2741\/e441","article-title":"Obesity-related glomerulopathy and podocyte injury: A mini review","volume":"4","author":"Camici","year":"2012","journal-title":"Front bioscience (Elite edition)"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)00272-5","article-title":"Primary glomerulonephritides","volume":"387","author":"Floege","year":"2016","journal-title":"Lancet (London England)"},{"key":"B92","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0100835","article-title":"Smoking is a risk factor for the progression of idiopathic membranous nephropathy","volume":"9","author":"Yamaguchi","year":"2014","journal-title":"PloS One"},{"key":"B93","article-title":"Kidney disease: improving global outcomes glomerular diseases work G","volume-title":"Kdigo 2021 clinical practice guideline for the management of glomerular diseases","author":"Rovin","year":""},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.817","article-title":"Kidney damage from nonsteroidal anti-inflammatory drugs-myth or truth? Review of selected literature","volume":"9","author":"Dro\u017cd\u017cal","year":"2021","journal-title":"Pharmacol Res Perspect"},{"key":"B95","doi-asserted-by":"publisher","first-page":"68","DOI":"10.3390\/jcm13010068","article-title":"The role of renal pla2r staining combined with serum pla2r antibody in membranous nephropathy risk stratification","volume":"13","author":"Hu","year":"2023","journal-title":"J Clin Med"},{"key":"B96","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.015","article-title":"Executive summary of the kdigo 2021 guideline for the management of glomerular diseases","volume":"100","author":"Rovin","year":"2021","journal-title":"Kidney Int"},{"key":"B97","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1186\/s12911-024-02568-2","article-title":"A dynamic online nomogram for predicting renal outcomes of idiopathic membranous nephropathy","volume":"24","author":"Wang","year":"2024","journal-title":"BMC Med Inf decision making"},{"key":"B98","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.909503","article-title":"Post-transplant thrombotic microangiopathy due to a pathogenic mutation in complement factor I in a patient with membranous nephropathy: case report and review of literature","volume":"13","author":"Saleem","year":"2022","journal-title":"Front Immunol"},{"key":"B99","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2025.04.005","article-title":"Impact of time-to-treatment on outcomes in autoimmune membranous nephropathy","volume":"10","author":"Hamilton","year":"2025","journal-title":"Kidney Int Rep"},{"key":"B100","doi-asserted-by":"publisher","DOI":"10.2174\/0929867329666220825121304","article-title":"Sglt-2 inhibitors and nephroprotection in patients with diabetic and non-diabetic chronic kidney disease","volume":"30","author":"Sarafidis","year":"2023","journal-title":"Curr medicinal Chem"},{"key":"B101","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2018.03.002","article-title":"Treatment and clinical outcomes of elderly idiopathic membranous nephropathy: A multicenter cohort study in korea","volume":"76","author":"Bae","year":"2018","journal-title":"Arch gerontology geriatrics"},{"key":"B102","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-023-02439-6","article-title":"A case series of fabry diseases with ckd in Japan","volume":"28","author":"Yusei","year":"2024","journal-title":"Clin Exp Nephrol"},{"key":"B103","doi-asserted-by":"publisher","DOI":"10.1172\/jci181397","article-title":"Hold the salt for kidney regeneration","volume":"134","author":"Xia","year":"2024","journal-title":"J Clin Invest"},{"key":"B104","doi-asserted-by":"publisher","first-page":"469","DOI":"10.3390\/nu13020469","article-title":"Systematic review of nutrition supplements in chronic kidney diseases: A grade approach","volume":"13","author":"Lin","year":"2021","journal-title":"Nutrients"},{"key":"B105","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.476","article-title":"Personalized prophylactic anticoagulation decision analysis in patients with membranous nephropathy","volume":"85","author":"Lee","year":"2014","journal-title":"Kidney Int"},{"key":"B106","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1322646","article-title":"Defining the threshold: triglyceride to high-density lipoprotein cholesterol (Tg\/hdl-C) ratio\u2019s non-linear impact on tubular atrophy in primary membranous nephropathy","volume":"15","author":"Guan","year":"2024","journal-title":"Front Endocrinol"},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2021.1879853","article-title":"Statins can benefit patients with primary membranous nephropathy on venous thromboembolism","volume":"43","author":"Zou","year":"2021","journal-title":"Renal failure"},{"key":"B108","doi-asserted-by":"publisher","first-page":"1997","DOI":"10.3390\/medicina59111997","article-title":"How to choose the right treatment for membranous nephropathy","volume":"59","author":"Peritore","year":"2023","journal-title":"Medicina (Kaunas Lithuania)"},{"key":"B109","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.04.024","article-title":"Acute kidney injury complicating nephrotic syndrome of minimal change disease","volume":"94","author":"Meyrier","year":"2018","journal-title":"Kidney Int"},{"key":"B110","doi-asserted-by":"publisher","DOI":"10.1042\/cs20200955","article-title":"Autoimmune-mediated renal disease and hypertension","volume":"135","author":"Boesen","year":"2021","journal-title":"Clin Sci (London England: 1979)"},{"key":"B111","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1053\/j.ajkd.2023.10.013","article-title":"Anti-phospholipase A2 receptor 1 and anti-cysteine rich antibodies, domain recognition and rituximab efficacy in membranous nephropathy: A prospective cohort study","volume":"83","author":"Ruggenenti","year":"2024","journal-title":"Am J Kidney diseases: Off J Natl Kidney Foundation"},{"key":"B112","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.0000000694","article-title":"Predicting remission in anti-pla2r antibody-associated membranous nephropathy: A secondary analysis of the gemritux, mentor and starmen trials","volume":"20","author":"Barbour","year":"2025","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B113","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfab356","article-title":"The role of pla2r antibody monitoring: what we know and what we do not know","volume":"38","author":"Ronco","year":"2023","journal-title":"Nephrology dialysis transplantation: Off Publ Eur Dialysis Transplant Assoc - Eur Renal Assoc"},{"key":"B114","doi-asserted-by":"publisher","DOI":"10.2147\/dmso.S366100","article-title":"Correlation of body mass index with clinicopathologic parameters in patients with idiopathic membranous nephropathy","volume":"15","author":"Chen","year":"2022","journal-title":"Diabetes Metab syndrome obesity: Targets Ther"},{"key":"B115","doi-asserted-by":"publisher","first-page":"sfae129","DOI":"10.1093\/ckj\/sfae129","article-title":"Ten tips on immunosuppression in primary membranous nephropathy","volume":"17","author":"Trujillo","year":"2024","journal-title":"Clin Kidney J"},{"key":"B116","doi-asserted-by":"publisher","DOI":"10.5414\/cn111287","article-title":"Effect of cyclophosphamide combined with glucocorticoid therapy on idiopathic membranous nephropathy: A multicenter open-label randomized controlled trial","volume":"102","author":"Wang","year":"2024","journal-title":"Clin Nephrol"},{"key":"B117","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.07.028","article-title":"Long-term follow-up of cyclical cyclophosphamide and steroids versus tacrolimus and steroids in primary membranous nephropathy","volume":"6","author":"Ramachandran","year":"2021","journal-title":"Kidney Int Rep"},{"key":"B118","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1053\/j.ajkd.2021.04.014","article-title":"Combination of rituximab, low-dose cyclophosphamide, and prednisone for primary membranous nephropathy: A case series with extended follow up","volume":"78","author":"Zonozi","year":"2021","journal-title":"Am J Kidney diseases: Off J Natl Kidney Foundation"},{"key":"B119","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1056\/NEJMoa1814427","article-title":"Rituximab or cyclosporine in the treatment of membranous nephropathy","volume":"381","author":"Fervenza","year":"2019","journal-title":"New Engl J Med"},{"key":"B120","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.09.014","article-title":"Neural epidermal growth factor-like 1 protein (Nell-1) associated membranous nephropathy","volume":"97","author":"Sethi","year":"2020","journal-title":"Kidney Int"},{"key":"B121","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.05.030","article-title":"Semaphorin 3b-associated membranous nephropathy is a distinct type of disease predominantly present in pediatric patients","volume":"98","author":"Sethi","year":"2020","journal-title":"Kidney Int"},{"key":"B122","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2018080852","article-title":"Exostosin 1\/exostosin 2-associated membranous nephropathy","volume":"30","author":"Sethi","year":"2019","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B123","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2022-0720","article-title":"Quantitative detection of anti-pla2r antibodies targeting different epitopes and its clinical application in primary membranous nephropathy","volume":"61","author":"Qin","year":"2023","journal-title":"Clin Chem Lab Med"},{"key":"B124","doi-asserted-by":"publisher","DOI":"10.1002\/jev2.12460","article-title":"Quantification of urinary podocyte-derived migrasomes for the diagnosis of kidney disease","volume":"13","author":"Yang","year":"2024","journal-title":"J extracellular vesicles"},{"key":"B125","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.0000000000000422","article-title":"Combined serologic and genetic risk score and prognostication of phospholipase A2 receptor-associated membranous nephropathy","volume":"19","author":"Hu","year":"2024","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B126","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12967-019-1792-8","article-title":"New risk score for predicting progression of membranous nephropathy","volume":"17","author":"Xiaofan","year":"2019","journal-title":"J Trans Med"},{"key":"B127","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw443","article-title":"Interstitial fibrosis scored on whole-slide digital imaging of kidney biopsies is a predictor of outcome in proteinuric glomerulopathies","volume":"33","author":"Mariani","year":"2018","journal-title":"Nephrology dialysis transplantation: Off Publ Eur Dialysis Transplant Assoc - Eur Renal Assoc"},{"key":"B128","doi-asserted-by":"publisher","DOI":"10.1080\/21655979.2021.1987080","article-title":"Associations between M-type phospholipase A2 receptor,Human leukocyte antigen gene polymorphisms and idiopathic membranous nephropathy","volume":"12","author":"Liu","year":"2021","journal-title":"Bioengineered"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1651810\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T05:26:20Z","timestamp":1757568380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1651810\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":128,"alternative-id":["10.3389\/fimmu.2025.1651810"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1651810","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]},"article-number":"1651810"}}