Primary membranous nephropathy (PMN), an autoimmune disease, is the most common cause of nephrotic syndrome in middle-aged non-diabetic adults. PMN pathophysiology includes Th1/Th2 paradigm. The IL-23/IL-17 pathway is implicated in autoimmune kidney disorders, but no study has examined its relationship with PMN. In several unrelated studies, PMN patients reported to have paradoxical IL-17 levels. This manuscript describes the best possible association of IL-23/IL-17 axis with PMN. Biopsy-proven PMN patients and age, gender-matched healthy controls were enrolled. Serum-PLA2R (Euroimmune, Germany), IL-23 and IL-17 (R&D; USA), was measured using ELISA along with biochemical parameters. Appropriate statistical tools were used for analysis. One hundred eighty-nine PMN patients (mean age 41.70 ± 12.53 years) and 100 controls (mean age 43.92 ± 10.93 years) were identified. One hundred forty were PLA2R-related. PMN patients had median proteinuria, serum albumin, and creatinine of 6.12 (3.875, 9.23) g/day, 2.32 (1.96, 2.9) g/dl, and 0.89 (0.7, 1.1) mg/dl, respectively. IL-17, but not IL-23, was significantly increased in PMN patients compared to controls (IL-17, median: 12.07 pg/ml (9.75, 24.56) vs median: 9.75 pg/ml (8.23, 17.03) p = 0.0002); (IL23, median: 6.04 pg/ml (4.22, 10.82) vs median: 5.46 pg/ml (3.34, 9.96) p = 0.142). IL-17 and IL-23 correlated significantly (p 0.05) in PMN patients, and similar trend was seen when grouped into PLA2R-related and -unrelated groups. The levels of IL-23 (p = 0.057) and IL-17 (p = 0.004) were high in MN patients that did not respond to the treatment. The current finding may indicate or suggest the involvement of IL-23/IL-17 PMN pathogenesis. A comprehensive investigation is needed to evaluate IL-23/IL-17 axis with renal infiltrating immune cells, and external stimuli.

原发性膜性肾病（PMN）是一种自身免疫性疾病，是中年非糖尿病成人肾病综合征的最常见原因。PMN 病理生理学包括 Th1/Th2 范式。IL-23/IL-17 通路与自身免疫性肾脏疾病有关，但尚无研究探讨其与 PMN 的关系。在几项不相关的研究中，PMN 患者的 IL-17 水平存在矛盾。本手稿描述了 IL-23/IL-17 轴与 PMN 的最佳可能关联。纳入经活检证实的 PMN 患者和年龄、性别匹配的健康对照。使用 ELISA 以及生化参数测量血清-PLA2R（Euroimmune，德国）、IL-23 和 IL-17（R&D；美国）。使用适当的统计工具进行分析。确定了 189 名 PMN 患者（平均年龄 41.70 ± 12.53 岁）和 100 名对照者（平均年龄 43.92 ± 10.93 岁）。一百四十个与 PLA2R 相关。PMN 患者的中位蛋白尿、血清白蛋白和肌酐分别为 6.12 (3.875, 9.23) g/天、2.32 (1.96, 2.9) g/dl 和 0.89 (0.7, 1.1) mg/dl。与对照组相比，PMN 患者的 IL-17（而非 IL-23）显着增加（IL-17，中位数：12.07 pg/ml (9.75, 24.56) vs 中位数：9.75 pg/ml (8.23, 17.03) p  = 0.0002 ）；（IL23，中位数：6.04 pg/ml (4.22, 10.82) vs 中位数：5.46 pg/ml (3.34, 9.96) p  = 0.142）。IL-17 和 IL-23 在 PMN 患者中显着相关（p  < 0.05），并且当分为 PLA2R 相关组和不相关组时也出现类似的趋势。 对治疗无反应的 MN 患者中IL-23 ( p  = 0.057) 和 IL-17 ( p = 0.004)水平较高。目前的发现可能表明或暗示 IL-23/IL-17 PMN 发病机制的参与。需要进行全面的研究来评估 IL-23/IL-17 轴与肾浸润免疫细胞和外部刺激的关系。