Animal models of idiopathic membranous nephropathy: Recent advances and future perspectives.

Idiopathic membranous nephropathy (IMN) is one of the main causes of adult nephrotic syndrome. A subset of untreated or inadequately treated patients eventually progress to end-stage renal disease (ESRD), posing a significant clinical challenge. Although the discovery of novel podocyte target antigens has deepened our understanding of IMN pathogenesis, the precise molecular mechanisms remain incompletely elucidated, and effective targeted therapies are still lacking. Animal models play an irreplaceable role in uncovering IMN pathogenesis and developing effective therapies. In recent years, with a deeper understanding of IMN, researchers have successfully established various animal models, including Heymann nephritis (HN), cationic bovine serum albumin (C-BSA), Aminopeptidase A (APA), thrombospondin type 1 domain-containing 7A (THSD7A)-related, and phospholipase A2 receptor (PLA2R)-related IMN models. These models have substantially advanced the simulation of pathological human IMN features. Notably, the development of human PLA2R1-related animal models marks a landmark breakthrough in this field, as these models are the first to recapitulate the immunopathological processes driven by a key human autoantigen in experimental animals. However, current animal models have their own limitations and still cannot fully replicate the complex pathological process of human IMN. This review summarizes recent progress in animal IMN models, analyzes their methods, pathological features, strengths, and limitations, and discusses future directions. Future model development should integrate advanced multi-omics and artificial intelligence (AI) to achieve greater accessibility and precision, enabling the construction of multidimensional models encompassing genetics, environment, and immunity, thereby enabling a leap from "disease simulation" to "personalized treatment".