Steroid-Sensitive Nephrotic Syndrome and Anti-Nephrin Antibodies: Pathogenic Insights and Therapeutic Opportunities.

Authors

Fabrizio Cristiano, Gustavo Aroca-Martinez, Carlos Guido Musso

Published in

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia. Volume 43. Issue 3. Jun 30, 2026. Epub Jun 30, 2026.

Abstract

Steroid-sensitive nephrotic syndrome (SSNS) encompasses a heterogeneous spectrum of podocytopathies, ranging from classical T-cell-mediated forms to those with an autoimmune component. Anti-nephrin autoantibodies have recently emerged as serological markers in a subset of immune-mediated podocytopathies, particularly in minimal change disease (MCD), primary FSGS, and immunoresponsive SSNS/SDNS. Although they correlate with disease activity and remission in selected cases, their sensitivity remains variable and assay standardization is still lacking. Rituximab shows the greatest efficacy in steroid-dependent or frequently relapsing forms, particularly in primary MCD/FSGS, while demonstrating limited benefit in genetic steroid-resistant disease. Overall, anti-nephrin autoantibodies should be regarded as promising yet still emerging biomarkers, potentially useful for refining phenotypic classification and supporting more personalized therapeutic strategies. Prospective studies and standardized detection protocols will be necessary before their integration into routine clinical practice can be recommended.

PMID:
42423055
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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