THSD7A (thrombospondin type 1 domain containing 7A) is a podocyte surface antigen that functions as a target of pathogenic circulating autoantibodies in membranous nephropathy (MN) 1. The soluble form promotes endothelial cell migration and filopodia formation during sprouting angiogenesis via a FAK-dependent mechanism, operating through actin cytoskeleton organization. In disease pathology, anti-THSD7A autoantibodies form immune complexes that accumulate along the glomerular basement membrane's subepithelial region, driving MN development 2. Anti-THSD7A antibodies account for 3-5% of primary MN cases, with diagnostic and prognostic significance comparable to anti-PLA2R antibodies 21. Serum anti-THSD7A antibody levels serve as important biomarkers correlating with disease severity and treatment response, with proteinuria persistence possible months after antibody clearance 2. These autoantibodies are causative agents in MN pathogenesis 1. Clinical management involves monitoring circulating autoantibodies to guide immunosuppressive therapy decisions, with B-cell depletion agents like rituximab showing efficacy in depleting anti-THSD7A levels 3. The identification of THSD7A as a pathogenic antigen has enabled more precise molecular diagnosis and improved disease management strategies for primary membranous nephropathy.