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31 papers 25 to 100 followers
By Juan Castellanos Physician, general practitioner in Bogota Colombia. Interested in Critical Care and Epidemiology.
Ken-Ei Sada, Masayoshi Harigai, Koichi Amano, Tatsuya Atsumi, Shouichi Fujimoto, Yukio Yuzawa, Yoshinari Takasaki, Shogo Banno, Takahiko Sugihara, Masaki Kobayashi, Joichi Usui, Kunihiro Yamagata, Sakae Homma, Hiroaki Dobashi, Naotake Tsuboi, Akihiro Ishizu, Hitoshi Sugiyama, Yasunori Okada, Yoshihiro Arimura, Seiichi Matsuo, Hirofumi Makino
OBJECTIVE: To compare disease severity classification systems for six-month outcome prediction in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: Patients with newly diagnosed AAV from 53 tertiary institutions were enrolled. Six-month remission, overall survival, and end-stage renal disease (ESRD)-free survival were evaluated. RESULTS: According to the European Vasculitis Study Group (EUVAS)-defined disease severity, the 321 enrolled patients were classified as follows: 14, localized; 71, early systemic; 170, generalized; and 66, severe disease...
September 2016: Modern Rheumatology
Marjolein Garsen, Marilen Benner, Henry B Dijkman, Toin H van Kuppevelt, Jin-Ping Li, Ton J Rabelink, Israel Vlodavsky, Jo H M Berden, Angelique L W M M Rops, Michael Elkin, Johan van der Vlag
Heparanase, a heparan sulfate (HS)--specific endoglucuronidase, mediates the onset of proteinuria and renal damage during experimental diabetic nephropathy. Glomerular heparanase expression is increased in most proteinuric diseases. Herein, we evaluated the role of heparanase in two models of experimental glomerulonephritis, being anti-glomerular basement membrane and lipopolysaccharide-induced glomerulonephritis, in wild-type and heparanase-deficient mice. Induction of experimental glomerulonephritis led to an increased heparanase expression in wild-type mice, which was associated with a decreased glomerular expression of a highly sulfated HS domain, and albuminuria...
April 2016: American Journal of Pathology
Alexander C Wiseman
Immunosuppressive agents are commonly used in the nephrologist's practice in the treatment of autoimmune and immune-mediated diseases and transplantation, and they are investigational in the treatment of AKI and ESRD. Drug development has been rapid over the past decades as mechanisms of the immune response have been better defined both by serendipity (the discovery of agents with immunosuppressive activity that led to greater understanding of the immune response) and through mechanistic study (the study of immune deficiencies and autoimmune diseases and the critical pathways or mutations that contribute to disease)...
February 5, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Dubravka Bobek, Jurica Vuković, Branko Malenica, Katarina Bojanić, Iva Rukavina, Marija Jelušić
Juvenile systemic lupus erythematosus (JSLE) is a systemic autoimmune chronic disease that can affect any part of the body. It is characterized by the formation of antibodies against nuclear antigens. Vasculitis may be found in SLE, but it scarcely complies with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) criteria. We report five cases of severe JSLE associated with AAV diagnosed between 1991 and 2013 in three university-based tertiary care centers. The patients (3 girls and 2 boys, aged 12 to 17) presented with a severe clinical picture and the following features: cytopenia (n=5), autoimmune hepatitis (n=3), lupus nephritis (n=1), pancreatitis (n=1), secondary antiphospholipid syndrome (n=2), impending respiratory failure (n=2), and gastrointestinal bleeding (n=1)...
2014: Acta Dermatovenerologica Croatica: ADC
S Thomas, D Ranganathan, L Francis, K Madhan, G T John
Complement component 3 glomerulopathy (C3G) is a recently defined entity comprising of dense deposit disease and C3 glomerulonephritis. The key histological feature is the presence of isolated C3 deposits without immunoglobulins. Often masqueradng as some of the common glomerulonephritides this is a prototype disorder occurring from dysregulated alternate complement pathway with recently identified genetic defects and autoantibodies. We review the pathophysiology, clinical features, and diagnostic and treatment strategies...
November 2014: Indian Journal of Nephrology
Mehreen Adhi, Sarah P Read, Jonathan J Liu, James G Fujimoto, Jay S Duker
Membranoproliferative glomerulonephritis (MPGN) type 2 is characterized by electron-dense deposits in the glomerular basement membrane and drusen-like deposits in Bruch's membrane. Over time, atrophic changes in the retina and retinal pigment epithelium occur, which can progress to choroidal neovascularization (CNV). This report describes a patient with MPGN type 2 who developed progressive loss of vision secondary to CNV. High-speed ultrahigh-resolution optical coherence tomography (UHR-OCT) showed an irregular Bruch's membrane that measured 10 μm beneath the foveal center...
November 2014: Ophthalmic Surgery, Lasers & Imaging Retina
Maurizio Bruschi, Maricla Galetti, Renato Alberto Sinico, Gabriella Moroni, Alice Bonanni, Antonella Radice, Angela Tincani, Federico Pratesi, Paola Migliorini, Corrado Murtas, Franco Franceschini, Barbara Trezzi, Francesca Brunini, Rita Gatti, Regina Tardanico, Giancarlo Barbano, Giorgio Piaggio, Piergiorgio Messa, Pietro Ravani, Francesco Scolari, Giovanni Candiano, Alberto Martini, Landino Allegri, Gian Marco Ghiggeri
Glomerular planted antigens (histones, DNA, and C1q) are potential targets of autoimmunity in lupus nephritis (LN). However, the characterization of these antigens in human glomeruli in vivo remains inconsistent. We eluted glomerular autoantibodies recognizing planted antigens from laser-microdissected renal biopsy samples of 20 patients with LN. Prevalent antibody isotypes were defined, levels were determined, and glomerular colocalization was investigated. Renal and circulating antibodies were matched, and serum levels were compared in 104 patients with LN, 84 patients with SLE without LN, and 50 patients with rheumatoid arthritis (RA)...
August 2015: Journal of the American Society of Nephrology: JASN
Olivier Niel, Aymeric Dallocchio, Marie-Christine Thouret, Vincent Guigonis, Élisabeth Cassuto, Véronique Frémeaux-Bacchi, Étienne Bérard
BACKGROUND: C3 nephritic factor (C3NeF) has been described in association with membranoproliferative glomerulonephritis and is involved in 80 % of cases of dense deposit disease. C3NeF is an immunoglobulin G (IgG) autoantibody which binds to the complement component 3 (C3) convertase C3bBb, thereby inhibiting its decay and leading to massive C3 cleavage. Commonly associated with C3NeF are low C3 levels, decreased total haemolytic complement (CH50) and normal C4 levels. C3NeF patients often present with proteinuria, haematuria and high blood pressure...
February 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Zahra Rezaieyazdi, Tahmine Tavakoli, Mohammad Khajehdaluee, Shahram Honarmand
Mycophenolate mofetil (MMF) has long been used to manage lupus nephritis. Despite research on its long-term efficacy, it is still warranted to conduct further investigation regarding its indications, safety and outcome. This study was intended to evaluate our proposed protocol in maintenance therapy with MMF. Twenty-four lupus nephritis patients were registered prior to their receiving 3-6 month induction therapy with monthly iv pulses of cyclophosphamide (CYC), followed by 24 month maintenance therapy using MMF and steroid...
2014: SpringerPlus
Zhihong Liu, Haitao Zhang, Zhangsuo Liu, Changying Xing, Ping Fu, Zhaohui Ni, Jianghua Chen, Hongli Lin, Fuyou Liu, Yongcheng He, Yani He, Lining Miao, Nan Chen, Ying Li, Yong Gu, Wei Shi, Weixin Hu, Zhengzhao Liu, Hao Bao, Caihong Zeng, Minlin Zhou
BACKGROUND: Treatment of lupus nephritis (LN) remains challenging. OBJECTIVE: To assess the efficacy and safety of a multitarget therapy consisting of tacrolimus, mycophenolate mofetil, and steroid compared with intravenous cyclophosphamide and steroid as induction therapy for LN. DESIGN: 24-week randomized, open-label, multicenter study. ( NCT00876616). SETTING: 26 renal centers in China. PATIENTS: Adults (aged 18 to 65 years) with biopsy-proven LN...
January 6, 2015: Annals of Internal Medicine
Laura C Plantinga, Rachel E Patzer, Cristina Drenkard, Michael R Kramer, Mitchel Klein, S Sam Lim, William M McClellan, Stephen O Pastan
OBJECTIVE: Providers recommend waiting to transplant patients with end-stage renal disease (ESRD) secondary to lupus nephritis (LN), to allow for quiescence of systemic lupus erythematosus (SLE)-related immune activity. However, these recommendations are not standardized, and we sought to examine whether duration of time to transplant was associated with risk of graft failure in US LN-ESRD patients. METHODS: Using national ESRD surveillance data (United States Renal Data System), we identified 4,743 US patients with LN-ESRD who received a first transplant on or after January 1, 2000 (followup through September 30, 2011)...
April 2015: Arthritis Care & Research
Uma Thanarajasingam, Timothy B Niewold
INTRODUCTION: Lupus nephritis (LN) is a significant contributor to morbidity and mortality in systemic lupus erythematosus (SLE). Current therapies for LN are limited by significant toxicities and high rates of relapse. A clear and present need exists for the development of effective, targeted and well-tolerated treatment strategies for LN. AREAS COVERED: In this review, the authors examine sirukumab , a monoclonal antibody with high affinity for IL-6, as a novel agent with potential for use in the treatment of SLE and LN in particular...
October 2014: Expert Opinion on Investigational Drugs
Radha Gajjar, Steven D Miller, Kevin E Meyers, Jill P Ginsberg
Cyclophosphamide continues to have an important role in the treatment of renal disease, including nephrotic syndrome and lupus nephritis, despite known complications of gonadotoxicity and potential infertility in both male and female patients. It is important that the physician recommending this therapy mitigates the effect of the drug on fertility by adhering to recommendations on dosing limits and offering fertility-preserving strategies. In addition to well-established methods, such as sperm banking and embryo cryopreservation, advances in reproductive technology have yielded strategies such as oocyte cryopreservation, resulting in more fertility-preserving options for the pediatric patient...
July 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
L Schiffer, K Worthmann, H Haller, M Schiffer
Different studies over the last decade have linked the B cell-attracting chemokine CXC ligand 13 (CXCL13) to the autoimmune disease systemic lupus erythematosus (SLE). A pathogenetic role of this chemokine for disease manifestation in SLE was described initially in mouse models for SLE. Mechanisms of CXCL13 actions were also identified in SLE patients. Moreover, various clinical studies have identified CXCL13 serum levels as a useful biomarker in patients with SLE of different ethnicities for disease activity...
January 2015: Clinical and Experimental Immunology
Takahisa Gono
N-Methyl-D-aspartate (NMDA) receptors are ligand-gated ion channels with crucial roles in synaptic transmission and central nervous system plasticity. Systemic lupus erythematosus (SLE) is a multi-system inflammatory disorder characterized by the presence of autoantibodies directed against double-stranded (ds) DNA. The pathophysiology of neuropsychiatric (NP) SLE is diverse and complicated. In SLE, anti-dsDNA antibody (Ab) cross-reacts with NMDA receptors. Serum anti-NMDA receptor Ab was found in 30% of SLE patients...
November 2013: Nihon Shinkei Seishin Yakurigaku Zasshi, Japanese Journal of Psychopharmacology
C F Christiansen, M Schmidt, A L Lamberg, E Horváth-Puhó, J A Baron, B Jespersen, H T Sørensen
BACKGROUND: Chronic kidney disease is associated with hemostatic derangements, including both procoagulant activity and platelet dysfunction, which may influence the risk of venous thromboembolism. However, data associating kidney disease with risk of venous thromboembolism are sparse. OBJECTIVES: We examined whether kidney disease is associated with increased risk of venous thromboembolism. METHODS: We conducted this nationwide case-control study using data from medical databases...
September 2014: Journal of Thrombosis and Haemostasis: JTH
A W S de Souza, W H Abdulahad, P Sosicka, J Bijzet, P C Limburg, C A Stegeman, M Bijl, J Westra, C G M Kallenberg
The objective of this study is to evaluate urinary high mobility group box 1 (HMGB1) levels as markers for active nephritis in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in comparison with urinary CD4(+) effector memory T cells and urinary monocyte chemoattractant protein-1 (MCP-1). Twenty-four AAV patients with active nephritis and 12 healthy controls (HC) were evaluated. In nine patients, samples were also obtained during remission. Urinary levels of HMGB1 were measured by Western blot...
November 2014: Clinical and Experimental Immunology
David Cucchiari, Giorgio Graziani, Claudio Ponticelli
Although prognosis of lupus nephritis has improved over time, a substantial amount of lupus patients still reach end-stage renal disease and require dialysis. Treatment of these patients can be challenging, since the disease poses a number of problems that can portend a poor prognosis, such as infections, lupus reactivations, vascular access thrombosis and cardiovascular complications. Consensus is lacking among investigators about the real incidence of these complications and related diagnosis and treatment...
August 2014: Nephrology, Dialysis, Transplantation
Michael M Ward
Recent clinical trials have provided evidence for the efficacy of low-dose intravenous cyclophosphamide and mycophenolate mofetil as induction treatment for patients with proliferative lupus nephritis in comparative trials with standard-dose intravenous cyclophosphamide. Trials of maintenance treatments have had more variable results, but suggest that the efficacy of mycophenolate mofetil may be similar to that of quarterly standard-dose intravenous cyclophosphamide and somewhat more efficacious than azathioprine...
August 2014: Rheumatic Diseases Clinics of North America
Hiroshi Watanabe, Mitsuru Sugimoto, Tomoyuki Asano, Shuzo Sato, Eiji Suzuki, Atsushi Takahashi, Kyoko Katakura, Hiroko Kobayashi, Hiromasa Ohira
OBJECTIVES: To assess the relationship between the complement activation route and clinical manifestations in systemic lupus erythematosus (SLE). METHODS: Patients with SLE in whom complement activation occurred were divided into two groups: those in whom the complement system was mainly activated through the classical pathway (low serum C3 and C4 levels; CP group); and those in whom the complement system was solely activated through the alternative pathway (low serum C3 with normal C4 levels; AP group)...
March 2015: Modern Rheumatology
2014-07-23 17:48:02
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