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lupus nephritis treatment

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https://www.readbyqxmd.com/read/29130759/preeclampsia-in-pregnancies-complicated-by-sle-nephritis-prophylactic-treatment-with-multidisciplinary-approach-are-important-keys-to-prevent-adverse-obstetrics-outcomes
#1
Federico Mecacci, Serena Simeone, Calogero Lino Cirami, Mauro Cozzolino, Caterina Serena, Marianna Pina Rambaldi, Pamela Gallo, Lorenzo Emmi, Daniele Cammelli, Giorgio Mello, Marco Matucci Cerinic
INTRODUCTION: Systemic lupus erythematosus (SLE) commonly affects women of childbearing age. Hypertension, antiphospholipid syndrome and lupus nephritis are risk factors for adverse maternal/fetal outcome. The aim of this retrospective cohort study is to compare pregnancy outcomes in patients with and without SLE nephritis, using a multidisciplinary approach and a broad prophylaxis protocol. MATERIALS AND METHODS: Data were collected from 86 pregnancies complicated by SLE...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29127458/safety-pharmacokinetics-and-pharmacodynamics-of-single-rising-doses-of-bi-655064-an-antagonistic-anti-cd40-antibody-in-healthy-subjects-a-potential-novel-treatment-for-autoimmune-diseases
#2
Fredrik N Albach, Frank Wagner, Andreas Hüser, Julia Igel, David Joseph, James Hilbert, Corinna Schoelch, Steven J Padula, Jürgen Steffgen
PURPOSE: The CD40-CD40L pathway is a promising treatment target for autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and lupus nephritis. The safety, pharmacokinetics and pharmacodynamics of BI 655064, a novel humanised antagonistic anti-CD40 monoclonal antibody, were investigated in this first-in-human trial. METHODS: Healthy male subjects (n = 72) were randomised 3:1, within each BI 655064 dose group, to single intravenous (IV; 0...
November 10, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29124008/rare-complicated-parapneumonic-effusion-mycoplasma-pneumoniae-with-new-onset-lupus-flare-case-report-and-literature-review
#3
Bharat Bajantri, Shaik Danial, Richard Duncalf, Misbahuddin Khaja
Mycoplasma pneumoniae has been associated with respiratory tract infections. Mycoplasma pneumoniae pneumonia-related pleural effusion is rarely reported. Extra-pulmonary abnormalities such as encephalitis, myocarditis, glomerulonephritis, and myringitis have been reported. However pulmonary manifestations in systemic lupus erythematosus include pneumonitis, pleurisy, interstitial lung disease, and thromboembolic disease. We present the case of a 26-year-old male who came for evaluation of fever, cough, and shortness of breath with right-sided chest pain...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29114699/glomerulonephritis-disease-pattern-at-saudi-tertiary-care-center
#4
Khalid I AlMatham, Ali F AlFayez, Raghdah A AlHarthi, Falah S AlMutairi, Fahad S Alrasheedi, Abdulrehman Mustafa, Mustafa Ahmed, Basim A AlMatouq, Fadil A AlRowaei
To assess changes in the pattern of glomerular diseases to help guide optimal allocation of resources, to focus future reasearch, and improve outcomes. Methods: A retrospective chart review was conducted on kidney biopsies taken between 2007 and 2016 at a single tertiary care center in Saudi Arabia (King Fahad Medical City, Riyadh) to evaluate the prevalence and pattern of glomerulonephritis (GN). Results: The most common primary GN in 102 biopsies from adult patients with a mean age of 28.9 ± 13.6 years and 40...
November 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29111236/reprint-of-dual-blockade-of-the-pro-inflammatory-chemokine-ccl2-and-the-homeostatic-chemokine-cxcl12-is-as-effective-as-high-dose-cyclophosphamide-in-murine-proliferative-lupus-nephritis
#5
Satish Kumar Devarapu, Santhosh Kumar Vr, Khader Valli Rupanagudi, Onkar P Kulkarni, Dirk Eulberg, Sven Klussmann, Hans-Joachim Anders
Induction therapy of proliferative lupus nephritis still requires the use of unselective immunosuppressive drugs with significant toxicities. In search of more specific drugs with equal efficacy but fewer side effects we considered blocking pro-inflammatory chemokine monocyte chemoattractant protein-1 (MCP-1/CCL2) and homeostatic chemokine stromal cell-derived factor-1 (SDF-1/CXCL12), which both contribute to the onset and progression of proliferative lupus nephritis yet through different mechanisms. We hypothesized that dual antagonism could be as potent on lupus nephritis as the unselective immunosuppressant cyclophosphamide (CYC)...
October 27, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/29108828/can-we-manage-lupus-nephritis-without-chronic-corticosteroids-administration
#6
REVIEW
Liz Lightstone, Andrea Doria, Hannah Wilson, Frank L Ward, Maddalena Larosa, Joanne M Bargman
The outcome of lupus nephritis (LN) has changed since the introduction of glucocorticoids (GCs), which dramatically reduced the mortality related to one of the most severe complications of systemic lupus erythematosus (SLE). Since the 1950's, other immunosuppressants, including biologic drugs (i.e. rituximab) have aided in maintaining remission, preserving kidney function, but not preventing treatment-related toxicity. GCs still remain the cornerstone in the treatment of SLE, including LN, and they are widely used in clinical practice...
November 3, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29108824/can-we-withdraw-immunosuppressants-in-patients-with-lupus-nephritis-in-remission-an-expert-debate
#7
REVIEW
Gabriella Moroni, Mariele Gatto, Francesca Raffiotta, Valentina Binda, Eleni Frangou, Liz Lightstone, Dimitrios T Boumpas
Lupus nephritis (LN) treatment requires an initial intensive period of therapy followed by a long-term maintenance treatment in order to stabilize disease control and eventually reach renal remission. In this section, Authors discuss the feasibility of safely lowering and even suspending maintenance therapy in LN patients having entered remission, highlighting hurdles in predicting the depth and durability of disease quiescence together with the need for minimizing potentially toxic therapies. Even though no firm conclusions can still be drawn, the treating physician has to find the wise balance between disease control and treatment-related drawbacks by following patients closely and recognizing as early as possible the ones who are likely to reach a deep and durable renal remission; there is consensus that is these are the only patients in whom a potential safe complete withdrawal can be foreseen so far...
November 3, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29106654/the-population-level-costs-of-immunosuppression-medications-for-the-treatment-of-glomerulonephritis-are-increasing-over-time-due-to-changing-patterns-of-practice
#8
Sean Barbour, Clifford Lo, Gabriela Espino-Hernandez, Sharareh Sajjadi, John Feehally, Scott Klarenbach, Jagbir Gill
Background: Immunosuppression (IS) is the main treatment for most types of glomerulonephritis (GN). Quantifying the cost of IS is necessary to ensure equitable access to therapies and optimal health outcomes, but the real-world cost of IS treatment for GN is largely unknown. We examined temporal changes in the population-level IS medication costs for GN over a 14-year period in a large Canadian province. Methods: We linked a provincial pathology database (containing all GN cases from 2000 to 2012) with renal and medication administrative databases to capture clinical characteristics and IS medications, with follow-up until 2013...
July 2, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29105558/comparison-of-disease-activity-between-tacrolimus-and-mycophenolate-mofetil-in-lupus-nephritis-a-randomized-controlled-trial
#9
N Kamanamool, A Ingsathit, S Rattanasiri, P Ngamjanyaporn, N Kasitanont, R Chawanasuntorapoj, W Pichaiwong, S Anutrakulchai, P Sangthawan, V Ophascharoensuk, Y Avihingsanon, V Sumethkul
We conducted a prospective multicenter, opened-label, parallel, randomized, controlled trial to compare tacrolimus (TAC) and mycophenolate mofetil (MMF) for induction and maintenance therapy in lupus nephritis (LN). Adult patients with biopsy-proven LN International Society of Nephrology/Renal Pathology Society classes III-V and active nephritis were to receive prednisolone (0.7-1.0 mg/kg/day for four weeks of run-in period and tapered) and randomly assigned to receive TAC (0.1 mg/kg/day) or MMF (1.5-2 g/day) as induction therapy for six months...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/29102373/transcriptomic-analysis-uncovers-novel-synergistic-mechanisms-in-combination-therapy-for-lupus-nephritis
#10
Jia Fu, Zichen Wang, Kyung Lee, Chengguo Wei, Zhengzhao Liu, Mingchao Zhang, Minlin Zhou, Minchao Cai, Weijia Zhang, Peter Y Chuang, Avi Ma'ayan, John Cijiang He, Zhihong Liu
A recent clinical study showed that combination therapy consisting of mycophenolate mofetil, tacrolimus and steroids was shown to be more effective in achieving complete remission in patients with severe forms of lupus nephritis than conventional therapy consisting of intravenous cyclophosphamide and steroids. To explore the underlying molecular and cellular mechanisms of increased efficacy of the combination therapy regimen, we employed a mouse model of lupus nephritis, MRL/lpr mice, and treated them with monotherapies of prednisone, mycophenolate mofetil, or tacrolimus, or with their combination...
November 1, 2017: Kidney International
https://www.readbyqxmd.com/read/29075476/phylogeographic-and-phylogenetic-analysis-for-tripterygium-species-delimitation
#11
Baowei Ma, Tianyuan Hu, Pei Li, Qingjun Yuan, Zhaoshou Lin, Yuhe Tu, Jia Li, Xianan Zhang, Xiaoyi Wu, Xiujuan Wang, Luqi Huang, Wei Gao
Tripterygium wilfordii (Celastraceae) is a traditional Chinese medicine; and the dried root and rhizome constitute the main officinal parts. Tripterygium wilfordii has been identified as a potential candidate for the treatment of systemic lupus erythematosus, rheumatoid arthritis, nephritis, asthma, leprosy, and cancer. The phylogenetic relationships within the Tripterygium genus are ambiguous; thus, our aim is to clarify the relationships within this genus using phylogeographic and phylogenetic analyses. Here, we first sequenced three plastid DNA regions (i...
October 2017: Ecology and Evolution
https://www.readbyqxmd.com/read/29062579/successful-treatment-of-hemophagocytic-lymphohistiocytosis-associated-with-lupus-nephritis-by-using-mycophenolate-mofetil
#12
Takashi Nawata, Makoto Kubo, Kosaku Shiragami, Yukinori Nakamura, Masafumi Yano
An estimated 0.9% to 2.4% of patients with systemic lupus erythematosus (SLE) also have hemophagocytic lymphohistiocytosis (HLH). HLH associated with autoimmune diseases is often refractory to corticosteroid treatment; thus, additional immunosuppressive drugs, such as cyclosporine, cyclophosphamide, or tacrolimus, are required. Here, we describe the case of a 44-year-old Japanese woman who developed HLH associated with lupus nephritis. Initially, her HLH was refractory to treatment with a corticosteroid, tacrolimus, and mizoribine...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/29050536/the-correlation-of-urinary-podocytes-and-podocalyxin-with-histological-features-of-lupus-nephritis
#13
D Ikuma, K Hiromura, H Kajiyama, J Suwa, H Ikeuchi, T Sakairi, Y Kaneko, A Maeshima, H Kurosawa, Y Hirayama, K Yokota, Y Araki, K Sato, Y F Asanuma, Y Akiyama, M Hara, Y Nojima, T Mimura
Objectives The objective of this study was to test the correlation of urinary podocyte number (U-Pod) and urinary podocalyxin levels (U-PCX) with histology of lupus nephritis. Methods This was an observational, cross-sectional study. Sixty-four patients were enrolled: 40 with lupus nephritis and 24 without lupus nephritis (12 lupus nephritis patients in complete remission and 12 systemic lupus erythematosus patients without lupus nephritis). Urine samples were collected before initiating treatment. U-Pod was determined by counting podocalyxin-positive cells, and U-PCX was measured by sandwich ELISA, normalized to urinary creatinine levels (U-Pod/Cr, U-PCX/Cr)...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/29043491/the-multifactorial-origin-of-posterior-reversible-encephalopathy-syndrome-in-cyclophosphamide-treated-lupus-patients
#14
REVIEW
Tatjana Zekić, Mirjana Stanić Benić, Ronald Antulov, Igor Antončić, Srđan Novak
The cyclophosphamide as a predisposing factor for Posterior Reversible Encephalopathy Syndrome (PRES) and therapeutic option for systemic lupus erythematosus (SLE) is still confusing. The first and only case of PRES, probably induced by cyclophosphamide, in Croatia followed by the findings of 36 SLE patients diagnosed with PRES after treatment with cyclophosphamide worldwide are described. An 18-year-old Caucasian female patient with a 1-year history of SLE was admitted to the hospital due to lupus nephritis and acute arthritis...
December 2017: Rheumatology International
https://www.readbyqxmd.com/read/29038713/coexistence-of-lupus-nephritis-and-sickle-cell-trait-an-electron-microscopic-assessment-of-renal-glomerular-damage-case-report-of-a-rare-association
#15
Yahya Elficki, Atif Rawas, Asseil Ali Bossei, Areej Bdawod, Reem Zabani, Bayan Shams
Because of similarities of the musculoskeletal, central nervous system, and renal manifestations in both diseases, diagnosing systemic lupus erythematosus (SLE) in sickle cell disease (SCD) patients can be difficult to establish. Although Sickle Cell Trait (SCT) is still considered a benign form of SCD, its impact on kidney injury and other renal manifestations is well recognized in the literature. In this case report, we look at the challenges that develop when diagnosing patients with a concurrence of both diseases and the importance of early recognition and treatment of lupus nephritis in SCT patients...
September 2017: Electronic Physician
https://www.readbyqxmd.com/read/29018537/safety-pharmacokinetics-and-pharmacodynamics-of-amg-811-an-anti-interferon-%C3%AE-monoclonal-antibody-in-sle-subjects-without-or-with-lupus-nephritis
#16
Michael J Boedigheimer, David A Martin, Zahir Amoura, Jorge Sánchez-Guerrero, Juanita Romero-Diaz, Alan Kivitz, Cynthia Aranow, Tak Mao Chan, Yip Boon Chong, Kit Chiu, Christine Wang, Winnie Sohn, Gregory E Arnold, Michael A Damore, Andrew A Welcher, Barbara A Sullivan, Brian L Kotzin, James B Chung
OBJECTIVE: To evaluate safety, pharmacokinetics and pharmacodynamics of anti-interferon (IFN)-γ monoclonal antibody AMG 811 in subjects with SLE without or with lupus nephritis (LN). METHODS: In this phase Ib, randomised, multiple-dose escalation study (NCT00818948), subjects without LN were randomised to subcutaneous AMG 811 (6, 20 or 60 mg) or placebo and subjects with LN were randomised to subcutaneous AMG 811 (20, 60 or 120 mg) or placebo every four weeks for three total doses...
2017: Lupus Science & Medicine
https://www.readbyqxmd.com/read/28993663/renal-iron-accumulation-occurs-in-lupus-nephritis-and-iron-chelation-delays-the-onset-of-albuminuria
#17
Eileen S Marks, Mathilde L Bonnemaison, Susan K Brusnahan, Wenting Zhang, Wei Fan, Jered C Garrison, Erika I Boesen
Proteins involved in iron homeostasis have been identified as biomarkers for lupus nephritis, a serious complication of systemic lupus erythematosus (SLE). We tested the hypothesis that renal iron accumulation occurs and contributes to renal injury in SLE. Renal non-heme iron levels were increased in the (New Zealand Black x New Zealand White) F1 (NZB/W) mouse model of lupus nephritis compared with healthy New Zealand White (NZW) mice in an age- and strain-dependent manner. Biodistribution studies revealed increased transferrin-bound iron accumulation in the kidneys of albuminuric NZB/W mice, but no difference in the accumulation of non-transferrin bound iron or ferritin...
October 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28992184/immune-complexes-containing-serum-b-cell-activating-factor-and-immunoglobulin-g-correlate-with-disease-activity-in-systemic-lupus-erythematosus
#18
Justa Friebus-Kardash, Leonore Branco, Camillo Ribi, Carlo Chizzolini, Uyen Huynh-Do, Denise Dubler, Pascale Roux-Lombard, Sebastian Dolff, Andreas Kribben, Ute Eisenberger, Marten Trendelenburg
Background: B-cell activating factor belonging to the TNF family (BAFF) is important for the survival of autoreactive B-cells in systemic lupus erythematosus (SLE). However, the association between serum BAFF levels and SLE disease activity is controversial. Independently, autoantibodies targeting BAFF [immunoglobulin G (IgG) anti-BAFF] have also been described in SLE patients and were associated with increased disease activity. The aim of our study was to analyse the relationship between SLE disease manifestations and serum levels of BAFF, IgG anti-BAFF and BAFF-IgG complexes...
August 8, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28987592/cathepsin-s-inhibition-suppresses-autoimmune-triggered-inflammatory-responses-in-macrophages
#19
Sophia Thanei, Michel Theron, Ana Patricia Silva, Bernhard Reis, Leonore Branco, Lucia Schirmbeck, Fabrice A Kolb, Wolfgang Haap, Thomas Schindler, Marten Trendelenburg
In several types of antigen-presenting cells (APCs), Cathepsin S (CatS) plays a crucial role in the regulation of MHC class II surface expression and consequently influences antigen (Ag) presentation of APCs to CD4(+) T cells. During the assembly of MHC class II-Ag peptide complexes, CatS cleaves the invariant chain p10 (Lip10) - a fragment of the MHC class II-associated invariant chain peptide. In this report, we used a selective, high-affinity CatS inhibitor to suppress the proteolytic activity of CatS in lymphoid and myeloid cells...
October 4, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/28982696/calcineurin-inhibitors-in-the-treatment-of-lupus-nephritis-a-hare-versus-turtle-story
#20
EDITORIAL
Isabelle Ayoub, Brad H Rovin
No abstract text is available yet for this article.
October 5, 2017: Journal of the American Society of Nephrology: JASN
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