Management of Lupus Nephritis

Houssiau, Frédéric

doi:10.1097/01.asn.0000140218.77174.0a

Cited by 72 publications

(42 citation statements)

References 102 publications

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“…3 is a systemic autoimmune disease where nephritis accounts for a substantial degree of the morbidity and mortality, both in patients and in mouse models of the disease (1)(2)(3). Unfortunately, the clinical management of nephritis in this autoimmune disease is still a difficult problem (3).…”

Section: S Ystemic Lupus Erythematosus (Sle)mentioning

confidence: 99%

Elevated Urinary VCAM-1, P-Selectin, Soluble TNF Receptor-1, and CXC Chemokine Ligand 16 in Multiple Murine Lupus Strains and Human Lupus Nephritis

Xie

Wang

et al. 2007

The Journal of Immunology

154

155

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In an effort to identify potential biomarkers in lupus nephritis, urine from mice with spontaneous lupus nephritis was screened for the presence of VCAM-1, P-selectin, TNFR-1, and CXCL16, four molecules that had previously been shown to be elevated in experimental immune nephritis, particularly at the peak of disease. Interestingly, all four molecules were elevated ∼2- to 4-fold in the urine of several strains of mice with spontaneous lupus nephritis, including the MRL/lpr, NZM2410, and B6.Sle1.lpr strains, correlating well with proteinuria. VCAM-1, P-selectin, TNFR-1, and CXCL16 were enriched in the urine compared with the serum particularly in active disease, and were shown to be expressed within the diseased kidneys. Finally, all four molecules were also elevated in the urine of patients with lupus nephritis, correlating well with urine protein levels and systemic lupus erythematosus disease activity index scores. In particular, urinary VCAM-1 and CXCL16 showed superior specificity and sensitivity in distinguishing subjects with active renal disease from the other systemic lupus erythematosus patients. These studies uncover VCAM-1, P-selectin, TNFR-1, and CXCL16 as a quartet of molecules that may have potential diagnostic significance in lupus nephritis. Longitudinal studies are warranted to establish the clinical use of these potential biomarkers.

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Section: S Ystemic Lupus Erythematosus (Sle)mentioning

confidence: 99%

Elevated Urinary VCAM-1, P-Selectin, Soluble TNF Receptor-1, and CXC Chemokine Ligand 16 in Multiple Murine Lupus Strains and Human Lupus Nephritis

Xie

Wang

et al. 2007

The Journal of Immunology

154

155

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“…SLE patients experience a waxing and waning disease course and a wide array of clinical manifestations, reflecting the systemic nature of the disease. The kidneys may become the target of SLE-induced inflammation at disease onset or during the disease course in up to 60% of cases (4).…”

mentioning

confidence: 99%

Predominance of CD8+ T lymphocytes among periglomerular infiltrating cells and link to the prognosis of class III and class IV lupus nephritis

Couzi

Merville

Déminière

et al. 2007

Arthritis & Rheumatism

122

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“…This regimen has been shown to be more efficient than CS alone (1), and the prognosis of LN has greatly improved in the last decades (2). Nevertheless, the occurrence of resistant or relapsing LN (respectively 20% and 33% after first-line treatment; 2), as well as the high frequency of deleterious effects of CYP and CS, make the use of alternative treatments necessary.…”

mentioning

confidence: 99%

Rituximab in Severe Lupus Nephritis

Melander

Sallée

Trolliet

et al. 2009

Clinical Journal of the American Society of Nephrology

150

107

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Background and objectives: Standard treatment for lupus nephritis, including corticosteroids and cyclophosphamide, is efficient but is still associated with refractory or relapsing disease, or severe deleterious effects. Rituximab, a monoclonal chimeric anti-B cell antibody, is increasingly used in patients with lupus nephritis, but reported series were small and had a short follow-up.Design, setting, participants, & measurements: The authors analyzed clinical and histologic data of 20 patients who were treated with rituximab for lupus nephritis and followed up for at least 12 mo.Results: Nineteen women and one man received rituximab as induction treatment for an active class IV (15 cases) or class V (5 cases) lupus nephritis. Rituximab was given for lupus nephritis refractory to standard treatment (12 cases), for relapsing disease (6 cases), or as first-line treatment (2 cases). Three patients received cyclophosphamide concomitantly with rituximab. Ten received new injections of rituximab as maintenance therapy. Side effects included mainly five infections and four moderate neutropenias. After a median follow-up of 22 mo, complete or partial renal remission was obtained in 12 patients (60%). Lupus nephritis relapsed in one patient, who responded to a new course of rituximab. The achievement of B cell depletion 1 mo after rituximab, which negatively correlated with black ethnicity and hypoalbuminemia, was strongly associated with renal response. Rapidly progressive glomerulonephritis did not respond to rituximab. Conclusion: Rituximab is an interesting therapeutic option in relapsing or refractory lupus nephritis when early B cell depletion is obtained.

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Management of Lupus Nephritis

Cited by 72 publications

References 102 publications

Elevated Urinary VCAM-1, P-Selectin, Soluble TNF Receptor-1, and CXC Chemokine Ligand 16 in Multiple Murine Lupus Strains and Human Lupus Nephritis

Elevated Urinary VCAM-1, P-Selectin, Soluble TNF Receptor-1, and CXC Chemokine Ligand 16 in Multiple Murine Lupus Strains and Human Lupus Nephritis

Predominance of CD8+ T lymphocytes among periglomerular infiltrating cells and link to the prognosis of class III and class IV lupus nephritis

Rituximab in Severe Lupus Nephritis

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