REVIEW article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1651810
Spontaneous Remission in Primary Membranous Nephropathy: Mechanisms, Predictive Factors, and Implications for Personalized Management
Provisionally accepted
- 1Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
- 2Zhejiang Chinese Medical University, Hangzhou, China
- 3Lishui TCM Hospital, Lishui, China
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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.
Keywords: Primary membranous nephropathy, spontaneous remission, anti-PLA2R antibody, risk stratification, precision therapy
Received: 22 Jun 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 Wu, Chen, He and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Youping Jin, Lishui TCM Hospital, Lishui, China
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