| An update on the pathogenesis and treatment of IgA nephropathy. | |
| | |
MedLine Citation:
|
PMID: 22318424 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Over the past two decades significant progress has been made in unravelling the complex pathogenesis of immunoglobulin A nephropathy (IgAN). Excess amounts of poorly galactosylated immunoglobulin (Ig)A1 in the serum appear to be the trigger for generation of glycan-specific IgG and IgA autoantibodies, resulting in the formation of circulating IgA immune complexes, which are pivotal to the development of nephritis. It remains unclear why there is an increase in poorly galactosylated IgA1 molecules in the serum in IgAN. One intriguing possibility is that this IgA is derived from displaced mucosal B cells, which have mis-homed from their mucosal induction sites to systemic sites, where they secrete polymeric, poorly galactosylated IgA directly into the circulation rather than onto mucosal surfaces. Lack of a clear appreciation of the origins of poorly galactosylated IgA1 and an incomplete understanding of immune complex formation have hampered development of specific therapeutic strategies to prevent mesangial IgA deposition. Clinicians have therefore been left to manage patients with generic therapies, mainly by control of blood pressure and renin-angiotensin blockade. A paucity of high-quality clinical trials has meant that evaluation of additional therapies, particularly immunosuppressive regimens, has been difficult and there remains a great deal of confusion over the optimum treatment of patients at high risk of progressive chronic kidney disease.Kidney International advance online publication, 8 February 2012; doi:10.1038/ki.2011.501. |
| | |
Authors:
|
Joanna K Boyd; Chee K Cheung; Karen Molyneux; John Feehally; Jonathan Barratt |
Related Documents
:
|
20519164 - Cytokine profiling of human peripheral blood cd4+ t lymphocytes reveals a new th-subpop... 14726234 - Pharmacological inhibition of mannheimia haemolytica lipopolysaccharide and leukotoxin-... 11751424 - Il-6 inhibits apoptosis and retains oxidative dna lesions in human gastric cancer ags c... 15369684 - Metalloproteinase and cytokine production by thp-1 macrophages following exposure to ch... 11150554 - Limited role of macrophages in generation of nerve injury-induced mechanical allodynia. 20519164 - Cytokine profiling of human peripheral blood cd4+ t lymphocytes reveals a new th-subpop... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-2-08 |
Journal Detail:
|
Title: Kidney international Volume: - ISSN: 1523-1755 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
|
Created Date: 2012-2-9 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
1] The John Walls Renal Unit, Leicester General Hospital, Leicester, UK [2] Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Lipopolysaccharide-pretreated plasmacytoid dendritic cells ameliorate experimental chronic kidney di...
Next Document: Engineers are from PDMS-land, Biologists are from Polystyrenia.