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Multi-hit model of IgA nephropathy

Explore the Pathogenesis of IgAN


Watch this video to discover the mechanism of disease of IgAN, a heterogeneous glomerular disease.

IgAN is Characterized by a Multi-hit Disease Model1


The Multi-hit Model

In Hit 4, overactivation of the endothelin and complement systems contributes to the progression of IgAN1

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Increased ETA receptor signaling in the kidney is associated with progression of IgAN1

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Complement, a key part of the immune system, is activated through the alternative pathway, and to a lesser extent the lectin pathway1,4,5

These processes may lead to proteinuria, inflammation, and fibrosis, which can cause progressive kidney damage1

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C3a, complement 3a; C3b, complement 3b; C5, complement 5; ET-1, endothelin-1; ETA, endothelin A; IgA1, immunoglobulin A1; MAC, membrane attack complex.
 
References: 1. Kohan DE, Barratt J, Heerspink HJL, et al. Targeting the endothelin A receptor in IgA nephropathy. Kidney Int Rep. 2023;8:2198-2210. doi:10.1016/j.ekir.2023.07.023 2. Rizk DV, Maillard N, Julian BA, et al. The emerging role of complement proteins as a target for therapy of IgA nephropathy. Front Immunol. 2019;10:504. doi:10.3389/fimmu.2019.00504 3. Lai KN, Tang SCW, Schena FP, et al. IgA nephropathy. Nat Rev Dis Primers. 2016;2:16001. doi:10.1038/nrdp.2016.1 4. Harris CL. Expanding horizons in complement drug discovery: challenges and emerging strategies. Semin Immunopathol. 2018;40(1):125-140. doi:10.1007/s00281-017-0655-8 5. Harris CL, Pouw RB, Kavanagh D, Sun R, Ricklin D. Developments in anti-complement therapy; from disease to clinical trial. Mol Immunol. 2018;102:89-119. doi:10.1016/j.molimm.2018.06.008