Evaluation and management of corticotropin allergy

Lee, Theodore M.; Grammer, Leslie C.; Shaughnessy, Martha A.; Patterson, Roy

doi:10.1016/0091-6749(87)90248-x

Cited by 10 publications

(1 citation statement)

References 15 publications

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“…Thus, allergy and anaphylaxis are reasonable concerns for melanocortin based therapy. However, in the past 60 years there were only several case reports on mild allergic/anaphylactic reactions to clinical use of natural or synthetic ACTH and most were limited to pediatric patients 97,98 , suggesting the antigenicity and immunogenicity of the melanocortin peptides might be minor.…”

Section: Side Effects Of Melanocortin Based Therapymentioning

confidence: 99%

Leveraging Melanocortin Pathways to Treat Glomerular Diseases

Gong

2014

Advances in Chronic Kidney Disease

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The melanocortin system is a neuroimmunoendocrine hormone system that constitutes the fulcrum in the homeostatic control of a diverse array of physiological functions, including melanogenesis, inflammation, immunomodulation, adrenocortical steroidogenesis, hemodynamics, natriuresis, energy homeostasis, sexual function and exocrine secretion. The kidney is a quintessential effector organ of the melanocortin hormone system with melanocortin receptors abundantly expressed by multiple renal paranchymal cells, including podocytes, mesangial cells, glomerular endothelial cells and renal tubular cells. Converging evidence unequivocally demonstrates that the melanocortin based therapy by using the melanocortin peptide adrenocorticotropic hormone (ACTH) is prominently effective in inducing remission of steroid resistant nephrotic syndrome caused by a variety of glomerular diseases, including membranous nephropathy and podocytopathies such as minimal change disease and focal segmental glomerulosclerosis, suggesting a steroidogenic independent melanocortin mechanism. Mechanistically, ACTH and other melanocortin peptides as well as synthetic melanocortin analogues possess potent proteinuria reducing and renoprotective effects that could be attributable to both direct protection of glomerular cells and systemic immunomodulation. Thus, leveraging melanocortin signaling pathways by using either the existing U.S. Food and Drug Administration approved melanocorin peptide ACTH or novel synthetic melanocortin analogues represents a promising and pragmatic therapeutic strategy for glomerular diseases. This review article introduces the biophysiology of melanocortin hormone system with emphasis on the kidney as the target organ, discusses the existing clinical and experimental data on melanocortin treatments for glomerular diseases, elucidates the potential mechanisms of action, and describes the potential side effects of melanocortin based therapy.

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Section: Side Effects Of Melanocortin Based Therapymentioning

confidence: 99%