title: Anti-neutral endopeptidase, natriuretic peptides disarrangement, and proteinuria onset in membranous nephropathy.
abstract: Neutral endopeptidase (NEP) is the first podocytic antigen responsible for human membranous nephropathy (MN). Besides the prevailing pathogenetic mechanism of immune complex, NEP is also involved in the metabolism of natriuretic peptides (NP). The identification of anti-NEP antibodies in human MN suggests that the decreased circulating NEP may down-regulate the NP catabolism. In this context, we hypothesize that NP disarrangement secondary to anti-NEP antibodies may account, in part, for the onset of proteinuria in MN. Whereas the pathways for the onset of proteinuria caused by elevated NP level are still obscure. The data presented in this review focus on those which support this hypothesis with regards to evidence from the glomerular haemodynamic changes, endothelial permeability, glomerular basement membrane disruption, and podocyte detachment.
authors.affiliation: Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Ji-Xi Road, Hefei 230022, People's Republic of China. hupeng28@sohu.com
authors.forename: Peng
authors.initials: P
authors.lastname: Hu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xuan
authors.forename: Bo
authors.initials: B
authors.lastname: Hu
authors.forename: Ling
authors.initials: L
authors.lastname: Lu
authors.forename: Yuan Han
authors.initials: YH
authors.lastname: Qin
mesh_terms: D000888:Antibodies, Anti-Idiotypic / Q000378:metabolism; D000936:Antigen-Antibody Complex / Q000276:immunology / Q000378:metabolism; D050533:Glomerular Basement Membrane / Q000276:immunology / Q000473:pathology; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000276:immunology / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D045265:Natriuretic Peptides / Q000378:metabolism*; D015260:Neprilysin / Q000276:immunology / Q000378:metabolism*; D011507:Proteinuria / Q000209:etiology / Q000276:immunology / Q000378:metabolism / Q000473:pathology
chemical_list: D000888:Antibodies, Anti-Idiotypic; D000936:Antigen-Antibody Complex; D045265:Natriuretic Peptides; D015260:Neprilysin