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For severe cases, biologics and traditional systemic agents like methotrexate, retinoids, and cyclosporine are more common choices (Nakamura & Koo 2020

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While preliminary evidence identifies ferroptosis as a key pathogenic factor in IgA nephropathylinked to GPX4 downregulation, Gd-IgA1-induced mesangial cell injury, and the PPARFABP1ACSL4 regulatory axisand validates ferroptosis inhibitors as potential therapeutics, several critical, insufficiently addressed research gaps persist

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