PERSPECTIVE article

Front. Med.

Sec. Precision Medicine

Precision Targeting of Gut-Kidney Axis: Mucosal Immunomodulation in IgA Nephropathy–A Perspective

  • Yan’an People’s Hospital, Yan'an, China

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Abstract

IgA nephropathy (IgAN) is a primary glomerular disease closely linked to mucosal immune dysregulation, involving a complex interplay between intestinal immune homeostasis and renal injury. The "gut-kidney axis" has recently emerged as a central conceptual framework for understanding IgAN pathogenesis, connecting intestinal mucosal immunity with kidney pathology. This perspective article scrutinizes the mechanistic role of this axis, focusing on key processes such as the production of galactose-deficient IgA1, intestinal barrier dysfunction, and gut microbiota dysbiosis. Building on this foundation, we propose "precision targeting of the gut-kidney axis" as a novel therapeutic paradigm for mucosal immunomodulation in IgAN, and discuss integrated strategies ranging from microbial and barrier modulation to specific immune interventions. By emphasizing multi-target, cross-organ approaches, this paradigm offers a promising alternative to conventional therapies and provides a translational roadmap for developing mechanism-based treatments in IgAN.

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Keywords

Galactose-deficient IgA1, gut-kidney axis, IgA nephropathy, Immunomodulation, intestinal barrier, microbiota, mucosal immunity, targeted therapy

Received

10 January 2026

Accepted

20 February 2026

Copyright

© 2026 Sun and Yang. 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: Xia-xia Yang

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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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