Document Detail


Treatment of lupus nephritis: facing the era of immunotherapy.
MedLine Citation:
PMID:  18927528     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lupus nephritis (LN) is a major cause of morbidity and mortality, affecting over half of SLE patients. The traditional treatment protocol with cyclophosphamide and corticosteroids dramatically improved patient and renal survival, but conferred a heavy burden of side effects. In addition, not all patients respond to first-line immunosuppression; 35% suffer at least one episode of renal relapse and 5-20% develop end-stage renal disease. Over the last decade, the increasing understanding of the complex pathogenesis underlying lupus nephritis and accelerating advances in molecular and cellular immunology have paved the way for development of immunomodulatory therapies for LN. In contrast to the global immunosuppressive effects of conventional treatment, these biologic agents target specific pathways that contribute to the inflammatory response, aiming to reduce tissue damage while preserving immunocompetence. The goal of this review is to highlight some of the more promising novel immunomodulators, including Abetimus sodium, Rituximab, Epratuzumab, Abatacept, Belimumab, Tocilizumab and Infliximab, and discuss how these agents affect central pathways in the pathogenesis of disease.
Authors:
A A Aran; C Putterman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Panminerva medica     Volume:  50     ISSN:  0031-0808     ISO Abbreviation:  Panminerva Med     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-17     Completed Date:  2009-01-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421110     Medline TA:  Panminerva Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  235-45     Citation Subset:  IM    
Affiliation:
Division of Rheumatology, Albert Einstein College of Medicine, Bronx, NY 10461, USA. aaran@aecom.yu.edu
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / therapeutic use
Antibodies, Monoclonal / therapeutic use
Autoantibodies / biosynthesis
B-Lymphocytes / drug effects,  immunology
Cytokines / antagonists & inhibitors
Disease Progression
Humans
Immunosuppressive Agents / therapeutic use
Immunotherapy* / adverse effects,  methods
Kidney Failure, Chronic / immunology,  prevention & control*
Lupus Nephritis / complications,  immunology,  therapy*
Mesenchymal Stem Cell Transplantation
Peripheral Blood Stem Cell Transplantation
Recurrence
T-Lymphocytes / drug effects,  immunology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Autoantibodies; 0/Cytokines; 0/Immunosuppressive Agents

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