{"id":"https://openalex.org/W7225793971","doi":"https://doi.org/10.3389/fimmu.2026.1963829","title":"From gut to glomerulus: the mucosa\u2013Gd-IgA1\u2013complement axis as an integrated treatment roadmap for IgA vasculitis nephritis, and the limits of extrapolation from IgA nephropathy","display_name":"From gut to glomerulus: the mucosa\u2013Gd-IgA1\u2013complement axis as an integrated treatment roadmap for IgA vasculitis nephritis, and the limits of extrapolation from IgA nephropathy","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225793971","doi":"https://doi.org/10.3389/fimmu.2026.1963829"},"language":"en","primary_location":{"id":"doi:10.3389/fimmu.2026.1963829","doi":"https://doi.org/10.3389/fimmu.2026.1963829","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1963829","pdf_url":null,"source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3389/fimmu.2026.1963829","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161466111","display_name":"Ziping Cai","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285929390","display_name":"Hubei University of Medicine","ror":"https://ror.org/01dr2b756","country_code":"CN","type":"education","lineage":["https://openalex.org/I1285929390"]},{"id":"https://openalex.org/I4210095236","display_name":"Suizhou Central Hospital","ror":"https://ror.org/00q3p9p08","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210095236"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Ziping Cai","raw_affiliation_strings":["Department of Gastroenterology, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)","institution_ids":["https://openalex.org/I1285929390","https://openalex.org/I4210095236"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161425959","display_name":"Lixia Dai","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285929390","display_name":"Hubei University of Medicine","ror":"https://ror.org/01dr2b756","country_code":"CN","type":"education","lineage":["https://openalex.org/I1285929390"]},{"id":"https://openalex.org/I4210095236","display_name":"Suizhou Central Hospital","ror":"https://ror.org/00q3p9p08","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210095236"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Lixia Dai","raw_affiliation_strings":["Department of General Internal Medicine, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of General Internal Medicine, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)","institution_ids":["https://openalex.org/I1285929390","https://openalex.org/I4210095236"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100361213","display_name":"Li Li","orcid":"https://orcid.org/0000-0002-6569-6008","observed_orcids":["https://orcid.org/0000-0002-6569-6008"]},"institutions":[{"id":"https://openalex.org/I1285929390","display_name":"Hubei University of Medicine","ror":"https://ror.org/01dr2b756","country_code":"CN","type":"education","lineage":["https://openalex.org/I1285929390"]},{"id":"https://openalex.org/I4210095236","display_name":"Suizhou Central Hospital","ror":"https://ror.org/00q3p9p08","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210095236"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Li Li","raw_affiliation_strings":["Department of Gastroenterology, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)","institution_ids":["https://openalex.org/I1285929390","https://openalex.org/I4210095236"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5153965967","display_name":"Xue Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285929390","display_name":"Hubei University of Medicine","ror":"https://ror.org/01dr2b756","country_code":"CN","type":"education","lineage":["https://openalex.org/I1285929390"]},{"id":"https://openalex.org/I4210095236","display_name":"Suizhou Central Hospital","ror":"https://ror.org/00q3p9p08","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210095236"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xue Li","raw_affiliation_strings":["Department of Gastroenterology, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)","institution_ids":["https://openalex.org/I1285929390","https://openalex.org/I4210095236"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161469608","display_name":"Hongyang Wu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285929390","display_name":"Hubei University of Medicine","ror":"https://ror.org/01dr2b756","country_code":"CN","type":"education","lineage":["https://openalex.org/I1285929390"]},{"id":"https://openalex.org/I4210095236","display_name":"Suizhou Central Hospital","ror":"https://ror.org/00q3p9p08","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210095236"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Hongyang Wu","raw_affiliation_strings":["Department of Emergency Medicine, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Emergency Medicine, Suizhou Central Hospital (Suizhou Hospital, Hubei University of Medicine)","institution_ids":["https://openalex.org/I1285929390","https://openalex.org/I4210095236"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5161469608"],"corresponding_institution_ids":["https://openalex.org/I1285929390","https://openalex.org/I4210095236"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"17","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":0.9258000254631042,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":0.9258000254631042,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10993","display_name":"Complement system in diseases","score":0.04309999942779541,"subfield":{"id":"https://openalex.org/subfields/2403","display_name":"Immunology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.02669999934732914,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C2781184683","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Nephropathy","level":3,"score":0.7049999833106995},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.6503000259399414},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5404999852180481},{"id":"https://openalex.org/C2779102806","wikidata":"https://www.wikidata.org/wiki/Q79453","display_name":"Immunoglobulin A","level":4,"score":0.44769999384880066},{"id":"https://openalex.org/C111684460","wikidata":"https://www.wikidata.org/wiki/Q334848","display_name":"Complement system","level":3,"score":0.4124000072479248},{"id":"https://openalex.org/C2777058396","wikidata":"https://www.wikidata.org/wiki/Q401402","display_name":"Nephritis","level":2,"score":0.4074999988079071},{"id":"https://openalex.org/C2780368995","wikidata":"https://www.wikidata.org/wiki/Q605006","display_name":"Glomerulonephritis","level":3,"score":0.40459999442100525},{"id":"https://openalex.org/C8891405","wikidata":"https://www.wikidata.org/wiki/Q1059","display_name":"Immune system","level":2,"score":0.3747999966144562},{"id":"https://openalex.org/C2776015282","wikidata":"https://www.wikidata.org/wiki/Q644318","display_name":"Vasculitis","level":3,"score":0.36320000886917114},{"id":"https://openalex.org/C2780091579","wikidata":"https://www.wikidata.org/wiki/Q9377","display_name":"Kidney","level":2,"score":0.335999995470047},{"id":"https://openalex.org/C159654299","wikidata":"https://www.wikidata.org/wiki/Q79460","display_name":"Antibody","level":2,"score":0.33000001311302185},{"id":"https://openalex.org/C10679952","wikidata":"https://www.wikidata.org/wiki/Q5308937","display_name":"Druggability","level":3,"score":0.32249999046325684},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.29910001158714294},{"id":"https://openalex.org/C189446657","wikidata":"https://www.wikidata.org/wiki/Q4736500","display_name":"Alternative complement pathway","level":4,"score":0.2922999858856201},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.28850001096725464},{"id":"https://openalex.org/C60644358","wikidata":"https://www.wikidata.org/wiki/Q128570","display_name":"Bioinformatics","level":1,"score":0.28600001335144043},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.26739999651908875},{"id":"https://openalex.org/C203880312","wikidata":"https://www.wikidata.org/wiki/Q14864145","display_name":"Lectin pathway","level":5,"score":0.2628999948501587},{"id":"https://openalex.org/C2780013240","wikidata":"https://www.wikidata.org/wiki/Q1035319","display_name":"Henoch-Schonlein purpura","level":4,"score":0.2590000033378601}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3389/fimmu.2026.1963829","doi":"https://doi.org/10.3389/fimmu.2026.1963829","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1963829","pdf_url":null,"source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3389/fimmu.2026.1963829","doi":"https://doi.org/10.3389/fimmu.2026.1963829","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1963829","pdf_url":null,"source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":123,"referenced_works":["https://openalex.org/W1013599560","https://openalex.org/W1834122159","https://openalex.org/W1920840831","https://openalex.org/W1967230281","https://openalex.org/W1967804880","https://openalex.org/W1974072757","https://openalex.org/W1974369780","https://openalex.org/W1986079204","https://openalex.org/W1989962362","https://openalex.org/W1994915550","https://openalex.org/W2002694041","https://openalex.org/W2005707979","https://openalex.org/W2011017816","https://openalex.org/W2019688206","https://openalex.org/W2026697506","https://openalex.org/W2028155613","https://openalex.org/W2028819377","https://openalex.org/W2031517139","https://openalex.org/W2034185130","https://openalex.org/W2034860684","https://openalex.org/W2036562668","https://openalex.org/W2040706558","https://openalex.org/W2048162256","https://openalex.org/W2054935974","https://openalex.org/W2082140799","https://openalex.org/W2088788139","https://openalex.org/W2099989381","https://openalex.org/W2101794801","https://openalex.org/W2108612466","https://openalex.org/W2121260651","https://openalex.org/W2125096231","https://openalex.org/W2126623226","https://openalex.org/W2137421192","https://openalex.org/W2142087910","https://openalex.org/W2147500454","https://openalex.org/W2149377529","https://openalex.org/W2151704308","https://openalex.org/W2154387748","https://openalex.org/W2154801271","https://openalex.org/W2154834722","https://openalex.org/W2155303581","https://openalex.org/W2163169095","https://openalex.org/W2398796024","https://openalex.org/W2600347335","https://openalex.org/W2604156122","https://openalex.org/W2727805585","https://openalex.org/W2746209383","https://openalex.org/W2762025355","https://openalex.org/W2768504529","https://openalex.org/W2772792185","https://openalex.org/W2782628349","https://openalex.org/W2784448875","https://openalex.org/W2790207363","https://openalex.org/W2794448415","https://openalex.org/W2799958297","https://openalex.org/W2804942357","https://openalex.org/W2806350527","https://openalex.org/W2895581671","https://openalex.org/W2921383353","https://openalex.org/W2922469909","https://openalex.org/W2937346600","https://openalex.org/W2951260600","https://openalex.org/W2965853783","https://openalex.org/W3012881939","https://openalex.org/W3023139456","https://openalex.org/W3048507351","https://openalex.org/W3048592173","https://openalex.org/W3085504674","https://openalex.org/W3131251745","https://openalex.org/W3159294113","https://openalex.org/W3162415721","https://openalex.org/W3165077576","https://openalex.org/W3172423688","https://openalex.org/W3188497543","https://openalex.org/W3191431536","https://openalex.org/W3200479416","https://openalex.org/W3205695625","https://openalex.org/W3210306774","https://openalex.org/W3217418082","https://openalex.org/W4205584002","https://openalex.org/W4206416282","https://openalex.org/W4210432619","https://openalex.org/W4210460883","https://openalex.org/W4210809287","https://openalex.org/W4280506915","https://openalex.org/W4282920264","https://openalex.org/W4283832676","https://openalex.org/W4296704205","https://openalex.org/W4303415526","https://openalex.org/W4304687573","https://openalex.org/W4313334095","https://openalex.org/W4322617042","https://openalex.org/W4375850366","https://openalex.org/W4381185249","https://openalex.org/W4385803938","https://openalex.org/W4386073090","https://openalex.org/W4386726965","https://openalex.org/W4387474219","https://openalex.org/W4388233273","https://openalex.org/W4390793335","https://openalex.org/W4391132324","https://openalex.org/W4391260511","https://openalex.org/W4392173293","https://openalex.org/W4392782444","https://openalex.org/W4393238164","https://openalex.org/W4393995034","https://openalex.org/W4399923662","https://openalex.org/W4400892990","https://openalex.org/W4402901102","https://openalex.org/W4403754434","https://openalex.org/W4403759533","https://openalex.org/W4404290105","https://openalex.org/W4405233624","https://openalex.org/W4409370315","https://openalex.org/W4411073903","https://openalex.org/W4412724763","https://openalex.org/W4414335273","https://openalex.org/W4414861087","https://openalex.org/W4415379478","https://openalex.org/W4415899604","https://openalex.org/W4416041942","https://openalex.org/W4417332376","https://openalex.org/W7128686524"],"related_works":[],"abstract_inverted_index":{"IgA":[0,38,189],"vasculitis":[1],"(IgAV),":[2],"the":[3,45,84,101,110,123,127,135,162,164,225,229,263],"commonest":[4],"systemic":[5,302],"small-vessel":[6],"vasculitis,":[7],"has":[8],"a":[9,18,68,91,178,210,281,290],"long-term":[10],"prognosis":[11],"decided":[12],"almost":[13,259],"entirely":[14],"by":[15,22,134,175],"its":[16,118,144],"nephritis,":[17],"burden":[19],"carried":[20],"disproportionately":[21],"adults":[23],"rather":[24,125,201],"than":[25,126,202],"children.":[26],"Yet":[27],"mechanistic":[28],"understanding":[29],"remains":[30,267],"piecemeal,":[31],"leaning":[32],"heavily":[33],"on":[34,90],"evidence":[35,60,147],"extrapolated":[36],"from":[37,49,73,244,269,283],"nephropathy":[39],"(IgAN).":[40],"We":[41,63],"therefore":[42],"separate":[43],"what":[44,50],"two":[46],"diseases":[47],"share":[48],"distinguishes":[51],"them":[52],"and":[53,58,137,151,166,190,195,254,256,271,289],"state":[54],"which":[55],"histological,":[56],"prognostic":[57],"therapeutic":[59],"transfers":[61],"legitimately.":[62],"read":[64],"IgAV":[65,141],"nephritis":[66],"as":[67,177],"single":[69],"druggable":[70],"axis":[71,276],"running":[72],"gut":[74],"to":[75,198,286,301],"glomerulus":[76],"through":[77,161],"four":[78],"connected":[79],"nodes.":[80],"It":[81],"begins":[82],"at":[83],"mucosa,":[85],"where":[86,140],"microbial":[87],"signals":[88],"acting":[89],"leaky":[92],"barrier":[93],"drive":[94],"production":[95],"of":[96,228,252],"galactose-deficient":[97],"IgA1":[98],"(Gd-IgA1)":[99],"that":[100,183,208],"four-hit":[102],"sequence":[103],"assembles":[104],"into":[105],"pathogenic":[106],"immune":[107],"complexes.":[108],"Although":[109],"glycosylation":[111],"defect":[112],"is":[113,131,196,241],"genetically":[114],"shared":[115],"with":[116,193,298],"IgAN,":[117],"reach":[119],"differs,":[120],"mapping":[121],"onto":[122,221],"kidney":[124,150],"vasculitis.":[128],"The":[129,238,275],"deposit":[130],"then":[132],"enlarged":[133],"alternative":[136],"lectin":[138],"pathways,":[139],"unusually":[142],"supplies":[143],"own":[145],"direct":[146],"across":[148],"skin,":[149],"urine,":[152],"before":[153],"age-modified":[154],"injury":[155,167],"develops":[156],"in":[157,206,273],"both":[158],"organs.":[159],"Viewed":[160],"axis,":[163],"complement":[165,185,219],"markers":[168,192],"it":[169],"sheds":[170],"can":[171],"be":[172,199],"specified,":[173],"node":[174],"node,":[176],"candidate,":[179],"hypothesis-generating":[180],"non-invasive":[181],"panel":[182],"pairs":[184],"fragments,":[186],"Gd-IgA1,":[187],"urinary":[188],"tubular-injury":[191],"histology":[194],"offered":[197],"tested":[200],"used,":[203],"whilst":[204],"agents":[205,264],"trials":[207,251,294],"target":[209],"proliferation-inducing":[211],"ligand":[212],"(APRIL),":[213],"B-cell":[214],"activating":[215],"factor":[216],"(BAFF)":[217],"or":[218],"map":[220],"defined":[222],"nodes":[223],"under":[224],"dual-driver":[226],"logic":[227],"2025":[230],"Kidney":[231],"Disease:":[232],"Improving":[233],"Global":[234],"Outcomes":[235],"(KDIGO)":[236],"guideline.":[237],"central":[239],"caveat":[240],"that,":[242],"apart":[243],"rituximab,":[245],"non-randomised":[246],"telitacicept":[247],"data,":[248],"negative":[249],"randomised":[250],"corticosteroids":[253],"cyclophosphamide,":[255],"vasculitis-specific":[257],"guidance,":[258],"every":[260],"result":[261],"for":[262,292,296],"mapped":[265],"here":[266],"borrowed":[268],"IgAN":[270],"unproven":[272],"IgAV.":[274],"nonetheless":[277],"offers":[278],"something":[279],"concrete:":[280],"route":[282],"scattered":[284],"literature":[285],"mechanism-matched":[287],"targets":[288],"priority":[291],"age-stratified":[293],"built":[295],"IgAV,":[297],"endpoints":[299],"suited":[300],"disease.":[303]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}
