Idiopathic Membranous Nephropathy: Diagnostic and Therapeutic Challenges

El-Husseini, Amr; Saxon, David; Jennings, Stuart; Cornea, Virgilius; Beck, Laurence H.; Sawaya, B. Peter

doi:10.1159/000444593

Cited by 10 publications

(10 citation statements)

References 33 publications

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“…Pentaacyltrehalose (PAT), [17] diacylated sulfo-glycolipidA c 2 SGL, [18] and polyacylated sulfoglycolipid SL-1 [19] are three representative examples of cell-wall lipids exclusively found in virulents trains of Mycobacterium tuberculosis.S ubstantial studies revealed that these lipids can not only potentially be used as biomarkers,b ut also are promising candidates for new tuberculosis vaccines. [17][18][19][20] The commons tructuralf eature of these lipids is encompassing at rehalose as ac entral carbohydrate, which is acylated with various long-chain fatty acids,t ypically polymethylated chiral deoxypropionate chains ( Figure 1). However,l ow availability of these lipids limited their furtherd evelopment as potential tuberculosis vaccines.…”

Section: Resultsmentioning

confidence: 99%

“…Mycolipenic acid 1,t he major acyl residue found in pentaacyltrehalose, has been shown to be ap otent inhibitor of leukocyte migration in vitro. [17,20] Mycolipenic acid 1 was first synthesized and characterized by Polgar et al in 1958 by al engthy route comprising ak inetic resolution. [21] Minnikin andc o-workers synthesized 1 as ar acemate in 1992.…”

Section: Resultsmentioning

confidence: 99%

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One‐Step Homologation for the Catalytic Asymmetric Synthesis of Deoxypropionates

Komiyama

et al. 2016

Chemistry A European J

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A one-step homologation protocol for the synthesis of natural products containing deoxypropionate motif is described by the combination of Zr-catalyzed asymmetric carboalumination of alkenes (ZACA)-Pd-catalyzed vinylation and ZACA-oxidation reaction. In contrast to most other synthetic strategies used to date that typically require three steps per deoxypropionate unit due to the functional-group interconversions, our one-step homologation strategy promises to provide a general and more efficient synthetic route toward deoxypropionate natural products as exemplified by significant improvements in the syntheses of intermediates and/or final products of mycolipenic acid 1 and its analogue 2, (-)-rasfonin, and syn- and anti-dicarboxylic acids 5 and 6.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

One‐Step Homologation for the Catalytic Asymmetric Synthesis of Deoxypropionates

Komiyama

et al. 2016

Chemistry A European J

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“…Membranous nephropathy (MN) is the most common case of the nephrotic syndrome in adults in addition to the focal segmental glomerulosclerosis (FSGS), [ 1 , 2 ] about 80% of cases are idiopathic membranous nephropathy (IMN) and about 20% of cases are secondary membranous nephropathy (SMN). [ 3 , 4 ] Patients with MN who did not find the reason for the disease were called IMN.…”

Section: Introductionmentioning

confidence: 99%

The prognostic value of phospholipase A2 receptor autoantibodies on spontaneous remission for patients with idiopathic membranous nephropathy

Shang

Tao

et al. 2018

Medicine

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Background:The presence of antibodies against phospholipase A2 receptor (PLA2R-Abs) in serum at diagnosis is reported to be related to the rate of spontaneous remission in patients with idiopathic membranous nephropathy (IMN); however, there is still lack of enough samples to illustrate this problem. Here, we conducted a comprehensive meta-analysis to investigate the prognostic value of PLA2R-Abs on spontaneous remission for IMN patients in the absence of immunosuppressive therapy.Methods:A systematic search of the PubMed, EMBASE, and Cochrane Central databases was performed for relevant original articles published until October 2017. All studies focus on spontaneous remission rates in IMN patients associated with PLA2R-Abs, the endpoint of interest is spontaneous remission rate. Risk ratio (RR) and corresponding 95% confidence intervals (CI) were carried out using a fixed or random effects model. The data were analyzed by Review Manager 5.3 software.Results:A total of 5 articles involving 190 patients were included in this meta-analysis. There were significant differences between the 2 groups in spontaneous remission rate. The seropositive of PLA2R-Abs measured at the time of diagnosis was negatively correlated with the likelihood of spontaneous remission (RR = 0.69; 95% CI, 0.56–0.87; P = .001).Conclusion:In PLA2R-Abs seronegative patients, the spontaneous remission rate is higher than that of PLA2R-Abs seropositive patients during symptomatic treatment. Therefore, in order to avoid malignant events caused by immunosuppressive therapy, maybe it is more beneficial to adopt conservative treatment for PLA2R-Abs seronegative patients at initial treatment.

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“…To our knowledge, only two other cases of HIV-associated MN in which tissue PLA2R staining was performed are reported in the literature, one of which was negative [24]. The second reported case was PLA2R positive (tissue stain), in a patient with concomitant HCV infection [25].…”

Section: Discussionmentioning

confidence: 94%

Membranous nephropathy in patients with HIV: a report of 11 cases

et al. 2020

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Background Membranous nephropathy (MN) has been recognized to occur in patients with human immunodeficiency virus (HIV) infection since the beginning of the HIV epidemic. The prevalence of phospholipase A2 receptor (PLA2R)-associated MN in this group has not been well studied. Methods We conducted a retrospective review of electronic pathology databases at three institutions to identify patients with MN and known HIV at the time of renal biopsy. Patients with comorbidities and coinfections known to be independently associated with MN were excluded. Results We identified 11 HIV-positive patients with biopsy-confirmed MN meeting inclusion and exclusion criteria. Patient ages ranged from 39 to 66 years old, and 10 of 11 patients (91%) were male. The majority of patients presented with nephrotic-range proteinuria, were on anti-retroviral therapy at the time of biopsy and had low or undetectable HIV viral loads. Biopsies from 5 of 10 (50%) patients demonstrated capillary wall staining for PLA2R. Measurement of serum anti-PLA2R antibodies was performed in three patients, one of whom had positive anti-PLA2R antibody titers. Follow-up data was available on 10 of 11 patients (median length of follow-up: 44 months; range: 4–145 months). All patients were maintained on anti-retroviral therapy (ARV) and 5 patients (52%) received concomitant immunosuppressive regimens. Three patients developed end-stage renal disease (ESRD) during the follow-up period. Conclusions MN in the setting of HIV is often identified in the setting of an undetectable viral loads, and similar to other chronic viral infection-associated MNs, ~ 50% of cases demonstrate tissue reactivity with PLA2R antigen, which may be seen without corresponding anti-PLA2R serum antibodies.

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Idiopathic Membranous Nephropathy: Diagnostic and Therapeutic Challenges

Cited by 10 publications

References 33 publications

One‐Step Homologation for the Catalytic Asymmetric Synthesis of Deoxypropionates

One‐Step Homologation for the Catalytic Asymmetric Synthesis of Deoxypropionates

The prognostic value of phospholipase A2 receptor autoantibodies on spontaneous remission for patients with idiopathic membranous nephropathy

Membranous nephropathy in patients with HIV: a report of 11 cases

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