https://scholars.lib.ntu.edu.tw/handle/123456789/635868
標題: | Targeted therapy in glomerular diseases | 作者: | Lin, Yi-Chan Gau, Tyng-Shiuan Jiang, Zheng-Hong KUAN-YU CHEN Tsai, Yi-Ting Lin, Kuan-Yu Tung, Hung-Ning FAN-CHI CHANG |
關鍵字: | Complement activation; IgA nephropathy; Immune-mediated glomerular disease; Membranous nephropathy; Targeted therapy | 公開日期: | 二月-2024 | 來源出版物: | Journal of the Formosan Medical Association = Taiwan yi zhi | 摘要: | Targeted therapy has emerged as a more precise approach to treat glomerular diseases, focusing on specific molecular or cellular processes that contribute to disease development or progression. This approach complements or replaces traditional immunosuppressive therapy, optimizes supportive care, and provides a more personalized treatment strategy. In this review, we summarize the evolving understanding of pathogenic mechanisms in immune-mediated glomerular diseases and the developing targeted therapies based on these mechanisms. We begin by discussing pan-B-cell depletion, anti-CD20 rituximab, and targeting B-cell survival signaling through the BAFF/APRIL pathway. We also exam specific plasma cell depletion with anti-CD38 antibody. We then shift our focus to complement activation in glomerular diseases, which is involved in antibody-mediated glomerular diseases, such as IgA nephropathy, membranous nephropathy, ANCA-associated vasculitis, and lupus nephritis. Non-antibody-mediated complement activation occurs in glomerular diseases, including C3 glomerulopathy, complement-mediated atypical hemolytic uremic syndrome, and focal segmental glomerulosclerosis. We discuss specific inhibition of terminal, lectin, and alternative pathways in different glomerular diseases. Finally, we summarize current clinical trials targeting the final pathways of various glomerular diseases, including kidney fibrosis. We conclude that targeted therapy based on individualized pathogenesis should be the future of treating glomerular diseases. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/635868 | ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2023.06.020 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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