| 洪家豪,卜宪敏.C4d在IgA肾病中的生物标志物价值：激活机制、风险分层与预后评估[J].济宁医学院学报,2026,49(4):370-374 |
| C4d在IgA肾病中的生物标志物价值：激活机制、风险分层与预后评估 |
| The biomarker value of C4d in IgA nephropathy:activation mechanisms,risk stratification,and prognosis assessment |
| 投稿时间：2026-04-16 |
| DOI：10.3969/j.issn.1000-9760.2026.04.013 |
| 中文关键词: IgA肾病 C4d 补体系统 凝集素途径 替代途径 肾组织沉积 无创生物标志物 风险分层 临床预后 |
| 英文关键词: IgA nephropathy C4d Complement system Lectin pathway Alternative pathway Renal tissue deposition Non-invasive biomarkers Risk stratification Prognosis |
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| 中文摘要: |
| IgA肾病（IgAN）是常见的原发性肾小球肾炎，临床与病理进展异质性强，部分患者可进展至终末期肾病。补体系统异常激活，尤其是凝集素途径与替代途径的协同作用，在IgAN发生发展中发挥关键作用。C4d是补体C4裂解后的稳定产物，其肾组织沉积可作为补体激活的“分子足迹”，与病理损伤、蛋白尿及不良肾结局密切相关，可用于风险分层。尿液C4d作为无创指标亦可反映肾内补体激活状态，并与疾病活动度、病理严重程度及长期预后相关。C4d检测有望用于分层管理与疗效监测，但仍需标准化检测流程与阈值，并通过大样本前瞻性研究进一步验证。本文就C4d在IgAN中的激活机制、作为病理及无创生物标志物的价值与局限性进行综述，展望其临床转化前景。 |
| 英文摘要: |
| IgA nephropathy (IgAN) is a common primary glomerulonephritis characterized by marked heterogeneity in clinical and pathological progression,with a subset of patients progressing to end-stage kidney disease.Abnormal complement activation,particularly the synergistic interplay between the lectin and alternative pathways,plays a pivotal role in the pathogenesis and progression of IgAN.C4d,a stable cleavage product of complement C4,serves as a "molecular footprint" of complement activation when deposited in renal tissue,and is closely associated with pathological injury,proteinuria,and adverse renal outcomes,thus enabling risk stratification.Urinary C4d,as a non-invasive biomarker,can also reflect intrarenal complement activation status and correlates with disease activity,histologic severity,and long-term prognosis.C4d testing holds promise for stratified management and therapeutic monitoring;however,standardization of assay protocols and cut-off values,along with further validation through large-scale prospective studies,are still required.This article reviews the activation mechanisms of C4d in IgAN,its value and limitations as both a tissue and non-invasive biomarker,and discusses its prospects for clinical translation. |
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