Anti-nephrin autoantibodies in post-transplant recurrence of focal segmental glomerulosclerosis: a review

Emerging studies have identified autoantibodies targeting the podocyte protein nephrin in patients with post-transplant recurrent focal segmental glomerulosclerosis (FSGS). These antibodies bind nephrin, directly disrupting its downstream signaling pathways. This disruption profoundly impacts podocyte structure and function, thereby enriching our understanding of antibody-mediated podocytopathies and their classification. The presence of these autoantibodies correlates with disease activity and offers considerable potential as an innovative biomarker for post-transplant recurrent FSGS. However, the precise contribution of these autoantibodies to the development of recurrent FSGS after transplantation remains elusive. In this review, we summarize the current research on anti-nephrin autoantibodies and discuss their applicability as a new biomarker for diagnosing, predicting outcomes, and guiding treatment in post-transplant recurrent FSGS.