Incidence and Relapse of Idiopathic Nephrotic Syndrome: Meta-analysis

Veltkamp, Floor; Rensma, Leonie R; Bouts, Antonia H.

doi:10.1542/peds.2020-029249

Cited by 29 publications

(29 citation statements)

References 98 publications

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“…NS is a disease with considerable morbidity and high risk for relapse [ 31 ]. Despite developed medical conditions and increasingly diverse ways of reducing proteinuria, NS still cannot be effectively treated [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Potential Molecular Mechanisms of Ephedra Herb in the Treatment of Nephrotic Syndrome Based on Network Pharmacology and Molecular Docking

Yao

Wang

Han

et al. 2022

BioMed Research International

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Objective. To explore the possible mechanisms of Ephedra herb (EH) in the treatment of nephrotic syndrome (NS) by using network pharmacology and molecular docking in this study. Methods. Active ingredients and related targets of EH were obtained from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, and the gene names corresponding to the proteins were found through the UniProt database. Then, target genes related to NS were screened out from GeneCards, PharmGKB, and OMIM databases. Next, the intersection targets were obtained successfully through Venn diagram, which were also seen as key target genes of EH and NS. Cytoscape 3.9.0 software was used to construct the effective “active ingredient-target” network diagram, and “drug-ingredient-target-disease (D-I-T-D)” network diagram. After that, the STRING database was used to construct a protein-protein interaction (PPI) network. Furthermore, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment involved in the targets were performed by the DAVID database and ClueGO plugin in Cytoscape. Finally, AutoDockTools software was used for molecular docking to verify the binding strength between main active ingredients and key target proteins. Results. A total of 22 main active ingredients such as quercetin, kaempferol, luteolin, and naringenin were obtained, which could act on 105 targets related to NS. Through PPI network, 53 core targets such as AKT1, TNF, IL6, VEGFA, and IL1B were found, which might play a crucial role in the treatment of NS. Meanwhile, these targets were significantly involved in PI3K-Akt signaling pathway, TNF signaling pathway, AGE-RAGE signaling pathway, hepatitis B, and pathways in cancer through GO and KEGG enrichment analysis. The docking results indicated that active ingredients such as kaempferol, luteolin, quercetin, and naringenin all had good binding to the target protein AKT1 or TNF. Among them, luteolin and naringenin binding with AKT1 showed the best binding energy (-6.2 kcal/mol). Conclusion. This study indicated that the potential mechanism of EH in treating NS may be related to PI3K-Akt signaling pathway, TNF signaling pathway, and AGE-RAGE signaling pathway, which provided better approaches for exploring the mechanism in treating NS and new ideas for further in vivo and in vitro experimental verifications.

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Section: Discussionmentioning

confidence: 99%

Potential Molecular Mechanisms of Ephedra Herb in the Treatment of Nephrotic Syndrome Based on Network Pharmacology and Molecular Docking

Yao

Wang

Han

et al. 2022

BioMed Research International

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“…Через такий неприйнятно високий рівень рецидивів діти піддаються ризику стероїдної залежності, побічних ефектів від кортикостероїдів і потребують призначення імуносупресивних стероїдзберігаючих засобів [1,5,7,9]. Велика увага приділяється оптимізації стероїдзберігаючих режимів, які б збільшили довгострокову ремісію [5,6,8,10,11].…”

Section: застосування ритуксимабу в лікуванні дітей з нефротичним син...unclassified

“…Нещодавно було переглянуто дозу й тривалість застосування КС при рецидивах НС для оптимізації швидкості ремісії і мінімізації токсичності КС [19,20]. Існує думка, що хоча оптимальний режим прийому КС для лікування рецидиву на сьогодні остаточно не визначено, малоймовірно, що в прагненні досягти довготривалої ремісії для дітей з НС доза або тривалість прийому КС істотно змінять його перебіг [10]. Проведений метааналіз 54 досліджень показує, що за останні майже 70 років досягнуто лише незначних успіхів у довгостроковій ремісії після лікування початкового прояву НС, а ризик рецидивів знизився несуттєво (з 78,4 до 66,2 %), незалежно від тривалості початкового лікування стероїдами [1,10].…”

Section: тема номера / Cover Storyunclassified

Rituximab use in the treatment of children with nephrotic syndrome

Вакуленко¹,

Lytvynova

Posmitjuha

2022

KIDNEYS

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Background. High recurrence rates of nephrotic syndrome in children and consequences in the form of steroid dependence and a high risk of side effects from corticosteroids as a result involve immunosuppressive steroid-preserving agents that would increase long-term remission. Rituximab, a chimeric anti-CD20 monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation, has been identified as a possible alternative treatment. The purpose of the study — to estimate the efficacy and safety of treatment recurrence of nephrotic syndrome in children using rituximab like we did it on three clinical cases. Materials and methods. The experience of rituximab in children was analyzed according to the databases of Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health and our own study of the treatment of three children with steroid-sensitive nephrotic syndrome was presented. Results. Treatment of nephrotic syndrome in three children who are 5 to 7 years with rituximab was conducted. One child had a second recurrence, two children had a first recurrence. The previous episode of nephrotic syndrome in all children was treated according to the recommendations of KDIGO 2021. All patients received rituximab (two intravenous injections two weeks apart) at a dose of 15 mg/kg for 5–6 hours with prior administration of methylprednisolone at a dose of 7–10 mg/kg. One child had side effects to the first administration of rituximab in the form of hypotension 70/40 and tachycardia 116–118. Reducing the speed of administration helped to eliminate side effects. The next injection in two weeks the child endured well. The other two children had no side effects to both rituximab injections. Moreover after 1 month of rituximab administration was without side effects or hematological changes. The next administration of rituximab is scheduled in 6 months after the last administration with prior control of CD20 level. Conclusions. In general a review of studies of rituximab confirms the high efficacy of the medication in nephrotic syndrome in children and the requirement for long-term evaluation. Rituximab can be considered as a first-line treatment for recurrence of nephrotic syndrome, including in resource-limited settings. Our own experience with rituximab in recurrent nephrotic syndrome has revealed slight short-term side effects.

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“…Nephrotic syndrome is one of the most common chronic kidney diseases (CKD) in children with an estimated incidence of 2.92 (range 1.15-16.9) per 100,000 children per year [1]. The majority of patients have steroid-sensitive disease (SSNS) that is characterized by complete remission following 4-6 weeks of daily corticosteroid therapy.…”

Section: Introductionmentioning

confidence: 99%