Table 1.

Epitope spreading in immune-mediated glomerulonephritis: mechanisms, clinical Implications, and therapeutic approaches.

Disease	Epitope Spreading	Molecular Targets	Clinical Implications
Membranous Nephropathy	Intramolecular, intermolecular (speculative)	PLA2R (CysR, CTLD1–CTLD8).	Worse prognosis, greater proteinuria, and higher risk of progression to ESRD.
Lupus Nephritis	Intramolecular and intermolecular	Nucleosomes, histones, snRNPs	Worsens renal involvement
IgA Nephropathy	Intermolecular (speculative)	Mesangial IgA1, external antigens	Limited evidence, potential role in immune complex formation
ANCA-Associated Vasculitis	Intramolecular	PR3, MPO	Higher relapse rate, severity of vascular injury
Anti-GBM Disease	Intramolecular	α3(IV)NC1, other α(IV) chains	Faster kidney failure progression

Overview of epitope spreading in autoimmune glomerulonephritis, summarizing the types, main targets, spreading mechanisms, and clinical impacts for five key pathologies.