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Lupus Nephritis

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31 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Cristina Pamfil, Zuzanna Makowska, Aurélie De Groof, Gaëlle Tilman, Sepideh Babaei, Christine Galant, Pauline Montigny, Nathalie Demoulin, Michel Jadoul, Selda Aydin, Ralf Lesche, Fiona McDonald, Frédéric A Houssiau, Bernard R Lauwerys
OBJECTIVES: Chronic renal impairment remains a feared complication of lupus nephritis (LN). The present work aimed at identifying mechanisms and markers of disease severity in renal tissue samples from patients with LN. METHODS: We performed high-throughput transcriptomic studies (Illumina HumanHT-12 v4 Expression BeadChip) on archived kidney biopsies from 32 patients with LN and eight controls (pretransplant donors). Histological staging (glomerular and tubular scores) and immunohistochemistry experiments were performed on the same and on a replication set of 37 LN kidney biopsy samples...
July 31, 2018: Annals of the Rheumatic Diseases
L Mu, Y Hao, Y Fan, H Huang, X Yang, A Xie, X Zhang, L Ji, Y Geng, Z Zhang
Objectives To investigate the mortality and causes of death in Chinese patients with systemic lupus erythematosus. Methods We collected the clinical data of all consecutive adult systemic lupus erythematosus patients at the Rheumatology department of Peking University First Hospital between January 2007 and December 2015. The primary causes of death were identified, the standardized mortality ratio and years of life lost were calculated, and the survival and variables associated with mortality were determined by Kaplan-Meier and Cox regression analysis respectively...
July 31, 2018: Lupus
Daniel J Wallace, Richard A Furie, Yoshiya Tanaka, Kenneth C Kalunian, Marta Mosca, Michelle A Petri, Thomas Dörner, Mario H Cardiel, Ian N Bruce, Elisa Gomez, Tara Carmack, Amy M DeLozier, Jonathan M Janes, Matthew D Linnik, Stephanie de Bono, Maria E Silk, Robert W Hoffman
BACKGROUND: Patients with systemic lupus erythematosus have substantial unmet medical need. Baricitinib is an oral selective Janus kinase (JAK)1 and JAK2 inhibitor that we hypothesised might have therapeutic benefit in patients with systemic lupus erythematosus. METHODS: In this double-blind, multicentre, randomised, placebo-controlled, 24-week phase 2 study, patients were recruited from 78 centres in 11 countries. Eligible patients were aged 18 years or older, had a diagnosis of systemic lupus erythematosus, and had active disease involving skin or joints...
July 21, 2018: Lancet
Y Ding, L-M Nie, Y Pang, W-J Wu, Y Tan, F Yu, M-H Zhao
Objective This study aimed to evaluate the clinical value of urinary biomarkers including kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and monocyte chemoattractant protein-1 (MCP-1) in lupus nephritis. Methods A total of 109 biopsy-proven lupus nephritis patients were included and 50 healthy individuals were used as normal controls. Urinary KIM-1, NGAL, and MCP-1 levels were measured by ELISA and their correlations with clinical and histological features were assessed...
July 18, 2018: Lupus
David J Tunnicliffe, Suetonia C Palmer, Lorna Henderson, Philip Masson, Jonathan C Craig, Allison Tong, Davinder Singh-Grewal, Robert S Flanc, Matthew A Roberts, Angela C Webster, Giovanni Fm Strippoli
BACKGROUND: Cyclophosphamide, in combination with corticosteroids, has been first-line treatment for inducing disease remission for proliferative lupus nephritis, reducing death at five years from over 50% in the 1950s and 1960s to less than 10% in recent years. Several treatment strategies designed to improve remission rates and minimise toxicity have become available. Treatments, including mycophenolate mofetil (MMF) and calcineurin inhibitors, alone and in combination, may have equivalent or improved rates of remission, lower toxicity (less alopecia and ovarian failure) and uncertain effects on death, end-stage kidney disease (ESKD) and infection...
June 29, 2018: Cochrane Database of Systematic Reviews
Youzhou Tang, Weiru Zhang, Minfeng Zhu, Li Zheng, Lingli Xie, Zhijiang Yao, Hao Zhang, Dongsheng Cao, Ben Lu
Effective treatment of lupus nephritis and assessment of patient prognosis depend on accurate pathological classification and careful use of acute and chronic pathological indices. Renal biopsy can provide most reliable predicting power. However, clinicians still need auxiliary tools under certain circumstances. Comprehensive statistical analysis of clinical indices may be an effective support and supplementation for biopsy. In this study, 173 patients with lupus nephritis were classified based on histology and scored on acute and chronic indices...
July 6, 2018: Scientific Reports
Yanyun Wang, Ye Tao, Yi Liu, Yi Zhao, Chao Song, Bin Zhou, Tao Wang, Linbo Gao, Lin Zhang, Huaizhong Hu
The current methods of monitoring the activity of lupus nephritis (LN) may cause unnecessary hospital visits or delayed immunosuppressive therapy. We aimed to find a urinary biomarker that could be developed as a home-based test for monitoring the activity of LN.Urine samples were collected immediately before a renal biopsy from patients of suspected active LN, and also from patients with inactive LN, systemic lupus erythematous without LN or healthy controls. Biomarker search was conducted on a cytokine antibody array and confirmation was done by quantitative evaluation with enzyme-linked immunosorbent assay...
June 2018: Medicine (Baltimore)
Cristina M Lanata, Joanne Nititham, Kimberly E Taylor, Sharon A Chung, Dara G Torgerson, Michael F Seldin, Bernardo A Pons-Estel, Teresa Tusié-Luna, Betty P Tsao, Eric F Morand, Marta E Alarcón-Riquelme, Lindsey A Criswell
OBJECTIVE: African Americans, East Asians, and Hispanics with systemic lupus erythematous (SLE) are more likely to develop lupus nephritis (LN) than are SLE patients of European descent. The etiology of this difference is not clear, and this study was undertaken to investigate how genetic variants might explain this effect. METHODS: In this cross-sectional study, 1244 SLE patients from multiethnic case collections were genotyped for 817,810 single-nucleotide polymorphisms (SNPs) across the genome...
2018: PloS One
Jiayue Wu, Jinghang Ma, Wei-Hong Zhang, Wen Di
Background: Although it is well established that systemic lupus erythematosus (SLE) negatively affects pregnancy outcomes, there is insufficient evidence on the effect of lupus nephritis (LN) on antenatal management and pregnancy outcomes. We performed a systematic review and meta-analysis to determine the association of LN with management and pregnancy outcomes in SLE patients. Methods: Embase, Medline, Cochrane, and were carefully searched for relevant English and Chinese language studies...
2018: Therapeutics and Clinical Risk Management
Hong Wang, Yi-le Ren, Jun Chang, Luo Gu, Ling-Yun Sun
Objectives: This study aims to conduct a meta-analysis to clarify the epidemiologic characteristics of biopsy-proven lupus nephritis (BPLN), including those relating to its prevalence and prognosis. Patients and methods: A literature search for relevant studies was conducted in the electronic databases of PubMed, Google Scholar, Embase, and Cochrane trial register. The following search terms were used for original articles published between January 1982 and April 2016: "lupus nephritis" or systemic lupus erythematosus ('SLE') or 'systemic lupus erythematous' and "pathology" or 'epidemiology' or prevalence or incidence...
March 2018: Archives of Rheumatology
Alejandra Londoño Jimenez, Wenzhu B Mowrey, Chaim Putterman, Jill Buyon, Beatrice Goilav, Anna Broder
OBJECTIVE: To characterize and compare the factors associated with tubulointerstitial inflammation (TII) and tubulointerstitial scarring, defined as interstitial fibrosis and/or tubular atrophy (IF/TA), in patients with lupus nephritis (LN). METHODS: We identified SLE patients with a renal biopsy consistent with LN between 2005 and 2017. Clinical data was collected from the medical records. Multivariable logistic regression models were fitted to assess factors associated with TII and with IF/TA (moderate-to-severe vs...
May 31, 2018: Arthritis & Rheumatology
B Obrișcă, R Jurubiță, A Andronesi, B Sorohan, C Achim, R Bobeica, M Gherghiceanu, E Mandache, G Ismail
Introduction Lupus nephritis (LN) affects nearly 60% of patients with systemic lupus erythematosus and up to 30% of them will progress to end-stage renal disease (ESRD), despite receiving aggressive immunosuppressive therapy. The prognostic value of ISN/RPS classification is controversial. Therefore, we aimed to identify clinical and pathological predictors of outcome in LN patients independent of this classification. Material and methods Thirty-seven patients with LN who underwent percutaneous kidney biopsy between 1997 and 2016 were included in this study...
August 2018: Lupus
S Qi, Q Chen, D Xu, N Xie, Y Dai
Systemic lupus erythematosus (SLE) is a type of autoimmune disease that damages multiple organs, including the heart, joints, liver and kidneys. The main characteristics of SLE are the deposition of circulating autoantibodies; autoantigen complexes in the renal system; and abnormal expression of complements, cytokines and chemokines. Lupus nephritis (LN) is the most serious manifestation of SLE and is characterized by inflammation of the kidney. This review summarizes recent clinical applications of protein biomarkers including autoantibodies, complements, cytokines and chemokines and some new protein biomarkers in SLE and LN...
January 1, 2018: Lupus
Kazunori Karasawa, Keiko Uchida, Tomo Takabe, Takahito Moriyama, Kosaku Nitta
Systemic lupus erythematosus (SLE) is an autoimmune chronic inflammatory disease that affects multiple organs and tissues. Lupus nephritis (LN) is a serious complication of SLE, which occurs at a high rate. Conventional treatment strategies of LN have been widely accepted by two concepts such as induction therapy and maintenance therapy. In LN induction therapy until recently, cyclophosphamide in combination with prednisone (PSL) has been the standard method of treatment for proliferative forms of LN. In the latest review, the combination of mycophenolate mofetil (MMF) is also considered a standard treatment option...
2018: Contributions to Nephrology
Pedro L Carreira, David A Isenberg
SLE has a complex pathogenesis, and multiple therapeutic targets have been discovered in recent years. In spite of belimumab being approved by the US Food and Drug Administration and the widespread use of rituximab, there have been many failed attempts to treat SLE successfully using biologic agents. In this review, we consider newer biologic approaches that might offer the hope of improving the outcome of SLE patients. These include the fully humanized anti-CD20 mAbs, PEGylated anti-CD40L, IFNα inhibitors, rigerimod and immune complexes blockade...
April 5, 2018: Rheumatology
Young Bin Joo, Young Mo Kang, Hyoun-Ah Kim, Chang-Hee Suh, Tae-Jong Kim, Yong-Wook Park, Jisoo Lee, Joo-Hyun Lee, Dae Hyun Yoo, Sang-Cheol Bae, Hye-Soon Lee, So-Young Bang
AIM: To compare renal outcomes between cyclophosphamide (CYC) and mycophenolate mofetil (MMF), and attempt to identify a predictor of renal survival. METHODS: A total of 99 patients with class III-V lupus nephritis (LN) and treated with CYC or MMF were enrolled. The remission rate and predictors of poor renal outcomes in LN were assessed. RESULTS: The mean age at LN diagnosis was 31.7 years. The baseline characteristics of the two groups were similar except for the chronicity index (3...
May 2018: International Journal of Rheumatic Diseases
Rudra Prosad Goswami, Geetabali Sircar, Hiramanik Sit, Alakendu Ghosh, Parasar Ghosh
OBJECTIVE: We report comparative efficacy between high-dose cyclophosphamide (HDCyC), low-dose cyclophosphamide (LDCyC), mycophenolate mofetil (MMF) and rituximab in patients with lupus nephritis (LN). METHODS: We analyzed comparative efficacy of 4 induction regimens of biopsy-proven LN: LDCyC: 500 mg fortnightly, HDCyC: 750 to 1200 mg monthly, MMF: 1.5 to 3 g/d, and rituximab. Outcomes of 4 groups were analyzed at the sixth month. RESULTS: Among total 222 patients, 26 received LDCyC (3-g total dose), 113 received HDCyC (mean, 5...
March 21, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Julie E Davidson, Qinggong Fu, Beulah Ji, Sapna Rao, David Roth, Laurence S Magder, Michelle Petri
OBJECTIVE: This observational study was a retrospective analysis of prospectively collected Hopkins Lupus Cohort data to compare longterm renal survival in patients with lupus nephritis (LN) who achieved complete (CR), partial (PR), or no remission following standard-of-care LN induction therapy. METHODS: Eligible patients with biopsy-proven LN (revised American College of Rheumatology or Systemic Lupus Collaborating Clinics criteria) were identified and categorized into ordinal (CR, PR, or no remission) or binary (response or no response) renal remission categories at 24 months post-diagnosis [modified Aspreva Lupus Management Study (mALMS) and modified Belimumab International Lupus Nephritis Study (mBLISS-LN) criteria]...
May 2018: Journal of Rheumatology
Eve M D Smith, Peng Yin, Andrea L Jorgensen, Michael W Beresford
BACKGROUND: Proteinuria is a well-known risk factor for progression of renal dysfunction in a variety of chronic kidney diseases. In adult-onset Systemic Lupus Erytematosus (SLE) patients with lupus nephritis (LN), proteinuria takes a significant period of time to normalise, with proteinuric remission being associated with improved renal survival and reductions in mortality. The length of time required to attain proteinuric remission has not previously been investigated in Juvenile-onset SLE (JSLE)...
February 21, 2018: Pediatric Rheumatology Online Journal
Ingeborg M Bajema, Suzanne Wilhelmus, Charles E Alpers, Jan A Bruijn, Robert B Colvin, H Terence Cook, Vivette D D'Agati, Franco Ferrario, Mark Haas, J Charles Jennette, Kensuke Joh, Cynthia C Nast, Laure-Hélène Noël, Emilie C Rijnink, Ian S D Roberts, Surya V Seshan, Sanjeev Sethi, Agnes B Fogo
We present a consensus report pertaining to the improved clarity of definitions and classification of glomerular lesions in lupus nephritis that derived from a meeting of 18 members of an international nephropathology working group in Leiden, Netherlands, in 2016. Here we report detailed recommendations on issues for which we can propose adjustments based on existing evidence and current consensus opinion (phase 1). New definitions are provided for mesangial hypercellularity and for cellular, fibrocellular, and fibrous crescents...
April 2018: Kidney International
2018-02-22 06:53:02
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