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lupus nephritis treatment

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https://www.readbyqxmd.com/read/28325471/can-we-identify-who-gets-benefit-or-harm-from-mycophenolate-mofetil-in-systemic-lupus-erythematosus-a-systematic-review
#1
Claudia Mendoza-Pinto, Carmelo Pirone, Daniëlle A van der Windt, Ben Parker, Ian N Bruce
OBJECTIVES: We aimed to summarize the evidence examining factors that predict differential response to mycophenolate mofetil (MMF) in systemic lupus erythematosus (SLE). METHODS: Systematic searches of randomized clinical trials (RCT) to identify predictors of the effects of MMF (moderators), and cohort studies to explore prognostic factors associated with MMF outcomes (response, relapse, or adverse events) were performed. Two reviewers independently assessed the methodological quality of RCTs using the Cochrane Collaboration risk of bias tool and cohort studies using the QUality In Prognosis Studies tool...
February 9, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28300543/antibodies-against-monomeric-c-reactive-protein-a-promising-biomarker-of-lupus-nephritis
#2
Katarzyna Jakuszko, Magdalena Krajewska, Katarzyna Kościelska-Kasprzak, Marta Myszka, Agata Sebastian, Katarzyna Gniewek, Piotr Wiland, Marian Klinger
OBJECTIVE AND AIM: A significant incidence of systemic lupus erythematosus (SLE), the severity of lupus nephritis and varying responses to treatment rationalize the search for novel biomarkers of disease activity. The aim of the study was to assess whether antibodies against monomeric C reactive protein (anti-mCRP) are associated with the presence of lupus nephritis, correlate with disease activity, and whether they can serve to evaluate a response to treatment. METHODS: The study involved 74 patients with lupus nephritis, 29 patients with systemic lupus without renal involvement and 31 patients with primary glomerulonephritis; the control group included 31 healthy volunteers...
March 11, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28274793/pkk-deficiency-in-b-cells-prevents-lupus-development-in-sle-lupus-mice
#3
D Oleksyn, J Zhao, A Vosoughi, J C Zhao, R Misra, A P Pentland, D Ryan, J Anolik, C Ritchlin, J Looney, A P Anandarajah, G Schwartz, L M Calvi, M Georger, C Mohan, I Sanz, L Chen
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies that can result in damage to multiple organs. It is well documented that B cells play a critical role in the development of the disease. We previously showed that protein kinase C associated kinase (PKK) is required for B1 cell development as well as for the survival of recirculating mature B cells and B-lymphoma cells. Here, we investigated the role of PKK in lupus development in a lupus mouse model...
March 6, 2017: Immunology Letters
https://www.readbyqxmd.com/read/28258497/treatment-of-pediatric-onset-lupus-nephritis-a-proposal-of-optimal-therapy
#4
REVIEW
Hiroshi Tanaka, Kensuke Joh, Tadaatsu Imaizumi
Lupus nephritis (LN) is one of the major clinical manifestations of systemic lupus erythematosus (SLE) which occurs frequently in the early stages of pediatric-onset cases. Since SLE is a chronic disease associated with frequent disease flares and effective and safe maintenance therapy is required for achieving a favorable outcome, optimal treatment for LN in pubertal patients is a great challenge that remains to be overcome. Although its etiology remains unclear, it has been reported that the innate and adaptive immune systems have been reported to play an important role in the pathogenesis of SLE...
March 3, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28258475/expanding-the-therapeutic-options-for-renal-involvement-in-lupus-eculizumab-available-evidence
#5
REVIEW
Savino Sciascia, Massimo Radin, Jinoos Yazdany, Maria Tektonidou, Irene Cecchi, Dario Roccatello, Maria Dall'Era
In this study, we aimed to systematically review available literature on the efficacy of eculizumab for the treatment of renal involvement in patients with systemic lupus erythematosus (SLE). We conducted a literature search developed a priori, to identify articles reporting clinical experience with the use of eculizumab in SLE patients, focusing on renal involvement. The search strategy was applied to Ovid MEDLINE, EMBASE, In-Process and Other Non-Indexed Citation, Cochrane Central Register of Controlled Trials and Scopus from 2006 to present...
March 3, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28245046/treatment-with-a-selective-histone-deacetylase-6-inhibitor-decreases-lupus-nephritis-in-nzb-w-mice
#6
Miranda D Vieson, Alexander M Gojmerac, Deena Khan, Rujuan Dai, John H van Duzer, Ralph Mazitschek, David L Caudell, Xiaofeng Liao, Xin M Luo, Christopher M Reilly
To date, there are 18 histone deacetylase (HDAC) enzymes, divided into four classes, which alter protein function by removing acetyl groups from lysine residues. Prior studies report that non-selective HDAC inhibitors decrease disease in lupus mouse models. Concern for adverse side effects of non-selective HDAC inhibition supports investigation of selective-HDAC inhibition. We hypothesized that a selective HDAC-6 inhibitor (HDAC6i) will alleviate disease in a mouse model of lupus by increasing acetylation of alpha-tubulin...
February 28, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28242713/activation-of-peroxisome-proliferator-activator-receptor-%C3%AE-%C3%AE-improves-endothelial-dysfunction-and-protects-kidney-in-murine-lupus
#7
Miguel Romero, Marta Toral, Iñaki Robles-Vera, Manuel Sánchez, Rosario Jiménez, Francisco O'Valle, Alba Rodriguez-Nogales, Francisco Pérez-Vizcaino, Julio Gálvez, Juan Duarte
Women with systemic lupus erythematosus exhibit a high prevalence of hypertension, endothelial dysfunction, and renal injury. We tested whether GW0742, a peroxisome proliferator activator receptor β/δ (PPARβ/δ) agonist, ameliorates disease activity and cardiovascular complications in a female mouse model of lupus. Thirty-week-old NZBWF1 (lupus) and NZW/LacJ (control) mice were treated with GW0742 or with the PPARβ/δ antagonist GSK0660 plus GW0742 for 5 weeks. Blood pressure, plasma double-stranded DNA autoantibodies and cytokines, nephritis, hepatic opsonins, spleen lymphocyte populations, endothelial function, and vascular oxidative stress were compared in treated and untreated mice...
April 2017: Hypertension
https://www.readbyqxmd.com/read/28219886/dependence-of-glomerulonephritis-induction-on-novel-intraglomerular-alternatively-activated-bone-marrow-derived-macrophages-and-mac-1-and-pd-l1-in-lupus-prone-nzm2328-mice
#8
Sun-Sang J Sung, Yan Ge, Chao Dai, Hongyang Wang, Shu Man Fu, Rahul Sharma, Young S Hahn, Jing Yu, Thu H Le, Mark D Okusa, Warren K Bolton, Jessica R Lawler
Glomerular damage mediated by glomerulus-infiltrating myeloid-derived cells is a key pathogenic event in lupus nephritis (LN), but the process is poorly understood. Confocal microscopy of kidney sections and flow cytometry analysis of glomerular cells from magnetic bead-purified glomeruli have identified glomerulus-infiltrating leukocyte populations in NZM2328 (NZM) lupus-prone mice with spontaneous chronic glomerulonephritis (GN) and anti-glomerular basement membrane-induced nephritis. The occurrence of a major glomerulus-infiltrating CD11b(+)F4/80(-)I-A(-) macrophage population exhibiting the markers programmed death ligand-1 (PD-L1), Mac-2, and macrophage mannose receptor (CD206) and producing Klf4, Il10, Retnla, Tnf, and Il6 mRNA, which are known to be expressed by alternatively activated (M2b) macrophages, correlated with proteinuria status...
April 1, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28216896/therapeutic-effect-of-dendrobium-candidum-on-lupus-nephritis-in-mice
#9
Qiang Wang, Peng Sun, Rui Wang, Xin Zhao
CONTEXT: Dendrobium candidum (D. candimum) widely is a functional drug. The curative effect of D. candidum on lupus nephritis has been studied in vivo. MATERIALS AND METHOD: The DBA/2 and B6D2F1 mice were used for this in vivo experiment. The 50% effective dose (ED50) was used to check the effective concentration for this study. Then the SCr, BUN, TC, TG, IL-6, IL-12, TNF-α, and IFN-γ levels were determined by kits. The output of urine protein was determined by means of Coomassie Brilliant Blue, and the auto-antibody dsDNA was determined with titer plate technology and indirect immunofluorescence...
January 2017: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/28213738/cytomegalovirus-infection-in-patients-with-lupus-nephritis-clinical-and-laboratory-features-and-therapeutic-considerations
#10
Lei Zhang, Jianling Tao, Yubing Wen, Li Li, Xueyi Wu, Xuewang Li, Xuemei Li
To better clarify the clinical features and therapeutic strategy of CMV infection in lupus nephritis patients, we retrospectively surveyed a total of 40 lupus nephritis patients, who had been hospitalized and underwent renal biopsy and diagnosed as having CMV infection during their hospitalization at our institution within the last 10 years. The percentage of CMV infections in the entire hospitalized lupus nephritis population was 5.3% (40/755). The principal clinical features of the 40 CMV-infected patients were hematological disorders (n = 25), fever (n = 21), liver dysfunction (n = 19), and respiratory symptoms (n = 12)...
February 17, 2017: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/28212922/organ-specific-biomarkers-in-lupus
#11
REVIEW
Haijing Wu, Jinrong Zeng, Jinghua Yin, Qiao Peng, Ming Zhao, Qianjin Lu
Systemic lupus erythematosus (SLE) is a complex and highly heterogeneous disease, which affects multiple organs, including joints, skin, kidneys, heart, hematopoietic system, and nerve system. While the etiopathogenesis of SLE still remains unclear, genetic susceptibilities and aberrant epigenetic modifications are believed to be involved. For precision therapy, it is necessary to assess accurately and objectively organ involvements and disease activity, which is difficult by current clinical laboratory tests...
February 14, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28207493/treatment-of-lupus-nephritis-current-paradigms-and-emerging-strategies
#12
Maria Dall'Era
PURPOSE OF REVIEW: Lupus nephritis is the most common organ-threatening manifestation of lupus and continues to result in end-stage renal disease. This review describes the contemporary treatment of lupus nephritis as well as emerging therapeutic strategies. RECENT FINDINGS: Lupus nephritis management consists of an initial (induction) phase and a maintenance (extended) phase in which steroids are used in combination with another immunosuppressive medication. Current treatments are incompletely effective and associated with substantial toxicity...
February 15, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28191596/efficacy-and-safety-of-rituximab-in-comparison-with-common-induction-therapies-in-pediatric-active-lupus-nephritis
#13
Biswanath Basu, Birendranath Roy, Binu George Babu
BACKGROUND: Childhood-onset lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE). Despite treatment-related toxicities, cyclophosphamide (CYC) and glucocorticoid-based treatment protocols are still considered standard therapy in managing this multisystem disorder. An effective and safe alternative induction regimen is needed. METHODS: Forty-four pediatric patients with active LN aged 3.5-13.8 (median 8.4) years, of whom 32 entered the study at diagnosis of SLE, were followed over 36 months...
February 12, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28185656/subacute-cutaneous-lupus-erythematosus-clinical-characteristics-disease-associations-treatments-and-outcomes-in-a-series-of-90%C3%A2-patients-at-mayo-clinic-1996-2011
#14
Dema T Alniemi, Albert Gutierrez, Lisa A Drage, David A Wetter
OBJECTIVE: To characterize the clinical presentation, laboratory studies, disease associations, and treatments of subacute cutaneous lupus erythematosus (SCLE). PATIENTS AND METHODS: A retrospective review of 90 patients with SCLE at Mayo Clinic from January 1, 1996, through October 28, 2011, was performed. RESULTS: The mean patient age at diagnosis was 61 years; 64 patients (71%) were women, and 11 cases (12%) were drug induced (1996-2000, no drug-induced cases; 2001-2005, 2 cases; 2006-2011, 9 cases)...
March 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28182833/comparative-effectiveness-of-mycophenolate-mofetil-for-the-treatment-of-childhood-onset-proliferative-lupus-nephritis
#15
Simon Y Tian, Earl D Silverman, Eleanor Pullenayegum, Patrick E Brown, Joseph Beyene, Brian M Feldman
OBJECTIVES: Although childhood-onset proliferative lupus nephritis (cPLN) leads to significant morbidity and mortality, there is no trial evidence to support the treatment effectiveness of any therapy for cPLN. Marginal structural models (MSMs) enable us to estimate treatment effectiveness using observational data while accounting for confounding by indication. METHODS: We used prospectively collected data to examine the effect of mycophenolate mofetil (MMF), compared to the use of other therapies, on the long-term outcome of our cPLN cohort (age at onset of PLN < 18 years)...
February 9, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28148285/clinicopathological-findings-treatment-response-and-predictors-of-long-term-outcome-in-a-cohort-of-lupus-nephritis-patients-managed-according-to-the-euro-lupus-regime-a-retrospective-analysis-in-sri-lanka
#16
Nalaka Herath, Neelakanthi Ratnatunga, Kosala Weerakoon, Abdul Wazil, Nishantha Nanayakkara
BACKGROUND: Despite the improvement in survival of patients with lupus nephritis (LN) globally, there is sparse data from Sri Lanka (SL). The current study aims to describe the clinicopathological findings, treatment response and predictors of long-term outcome of patients with WHO class III-IV LN in SL, managed according to the Euro-lupus regime. RESULTS: Of 72 patients, 64 were females. In half of them, LN was diagnosed within the 1st year of the illness. The most common presenting feature was sub-nephrotic proteinuria...
February 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28147262/efficacy-of-belimumab-on-renal-outcomes-in-patients-with-systemic-lupus-erythematosus-a-systematic-review
#17
REVIEW
S Sciascia, M Radin, J Yazdany, R A Levy, D Roccatello, M Dall'Era, M J Cuadrado
Both BLISS-52 and BLISS-76 international phase III trials in Systemic Lupus Erythematosus (SLE) met their primary outcomes; however, they were not designed to assess the efficacy of belimumab for the treatment of lupus nephritis (LN). LN is a frequent cause of SLE-associated morbidity and mortality, and emerging evidence suggests a potential therapeutic role for agents that target B lymphocyte stimulator (BLyS). We conducted a systematic review to identify data on the effect of belimumab on LN. A total of 2004 patients with SLE were identified from 11 studies...
January 29, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28143529/individualized-patient-decision-aid-for-immunosuppressive-drugs-in-women-with-lupus-nephritis-study-protocol-of-a-randomized-controlled-trial
#18
Jasvinder A Singh, Nipam Shah, Candace Green
BACKGROUND: Systemic Lupus erythematosus (SLE), also commonly referred to as lupus, is a rare, but sometimes, fatal disease, that primarily affects young women. Lupus nephritis, a common manifestation of lupus, is more common and more devastating in patients of minority race/ethnicity. Patients have negative views of immunosuppressive drugs for lupus nephritis due to a concern about side effects and under-appreciation of its benefit. We designed a study to assess the effectiveness of individualized, computerized patient decision-aid for immunosuppressive drugs for lupus nephritis compared to a standard pamphlet for patient decision-making...
January 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28133935/post-transplant-immune-complex-nephritis-in-a-patient-with-systemic-lupus-erythematosus-associated-with-anca-vasculitis
#19
Carlos Sanchez, Alejandra Rebolledo, Junior Gahona, Mauricio Rojas, Raquel Jiménez, Aurora Bojórquez
Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28120479/urinary-haptoglobin-alpha-1-anti-chymotrypsin-and-retinol-binding-protein-identified-by-proteomics-as-potential-biomarkers-for-lupus-nephritis
#20
Amita Aggarwal, Ranjan Gupta, V S Negi, Liza Rajasekhar, Ramnath Misra, Padam Singh, Vinita Chaturvedi, Sudhir Sinha
OBJECTIVE: Identification by proteomics and validation by ELISA of potential urinary biomarkers for lupus nephritis. METHODS: Study subjects comprised 88 systemic lupus erythematosus (SLE) patients and 60 controls (rheumatoid arthritis, diabetes mellitus and healthy individuals). Based on SLE disease activity index (SLEDAI) patients were classified as active renal (AR), active non-renal (ANR) or inactive disease (ID).Urinary proteins from a group of patients with AR or ID were resolved by two-dimensional gel electrophoresis and identified by MALDI-TOF-MS/MS...
January 24, 2017: Clinical and Experimental Immunology
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