Autoimmunoglobulin-triggered extracellular vesicles as new players in membranous nephropathy: friends or foes?

Membranous nephropathy (MN) is a rare autoimmune kidney disease characterized by the deposition of immune complexes (ICs) in the subepithelial space between podocytes and the glomerular basement membrane1. Deposition of ICs is associated with effacement of podocyte foot processes, leading to heavy proteinuria and kidney failure. Subepithelial ICs represent a long-standing hallmark of MN described more than 60 years ago, yet their appearance, clearance, and functional significance remain debated.