{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T18:57:22Z","timestamp":1784833042440,"version":"3.55.0"},"reference-count":63,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Membranous nephropathy is a disease that has been well documented, yet its etiopathogenesis has not been fully clarified and the distinction between its primary and secondary forms has not been completely categorized. The discovery of new antigens and antibodies reveals different percentages of positivity in secondary membranous nephropathy, which is a cause of great confusion and ambiguity not only in diagnosis but also in the choice of a therapeutic approach. The aim of this review is to summarize the literature on newly discovered antigens and antibodies, and to propose a pathogenetic model based on the role of the complement system and its activation pathways. In this model, antigens are categorized based on the type of immunoglobulin deposits and the putative complement pathways that they activate, which can help to differentiate primary from secondary membranous nephropathy. The model also reflects how the deposition of foreign antigens in the basement membrane can activate both the lectin and classical complement pathways, which may explain why positive antibodies are observed in both primary and secondary forms of membranous nephropathy.<\/jats:p>","DOI":"10.3390\/ijms27052423","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:22:14Z","timestamp":1772788934000},"page":"2423","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Membranous Nephropathy: Antigenic Landscape and a Novel Pathogenetic Model"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1362-0121","authenticated-orcid":false,"given":"Irina","family":"Zdravkova","sequence":"first","affiliation":[{"name":"Department of Propaedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria"},{"name":"Nephrology Clinic, University Hospital \u201cKaspela\u201d, 4000 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4091-4312","authenticated-orcid":false,"given":"Eduard","family":"Tilkiyan","sequence":"additional","affiliation":[{"name":"Nephrology Clinic, University Hospital \u201cKaspela\u201d, 4000 Plovdiv, Bulgaria"},{"name":"Second Department of Internal Diseases, Section \u201cNephrology\u201d, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7802-0576","authenticated-orcid":false,"given":"Desislava","family":"Bozhkova","sequence":"additional","affiliation":[{"name":"Department of General and Clinical Pathology, Faculty of Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria"},{"name":"Department of General and Clinical Pathology, University Hospital \u201cSveti Georgi\u201d, 4000 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4674-7949","authenticated-orcid":false,"given":"Yovko","family":"Ronchev","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, University Hospital \u201cKaspela\u201d, 4000 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Kirilov","sequence":"additional","affiliation":[{"name":"Nephrology Clinic, University Hospital \u201cKaspela\u201d, 4000 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1745-3579","authenticated-orcid":false,"given":"Teodor","family":"Kuskunov","sequence":"additional","affiliation":[{"name":"Department of Propaedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria"},{"name":"Nephrology Clinic, University Hospital \u201cKaspela\u201d, 4000 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atanas","family":"Lambrev","sequence":"additional","affiliation":[{"name":"Nephrology Clinic, University Hospital \u201cKaspela\u201d, 4000 Plovdiv, Bulgaria"},{"name":"Second Department of Internal Diseases, Section \u201cNephrology\u201d, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref_1","unstructured":"Coffman, T.M., Falk, R.J., Molitoris, B.A., and Schrier, R.W. 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