Advances in the treatment of IgA nephropathy with biological agents
Abstract Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease, and the “four‐hit” theory represents its currently accepted pathogenic mechanism. Mucosal immunity triggered by infections in the respiratory tract, intestines, or other areas leads to antigen presentation, T...
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Chronic Diseases and Translational Medicine |
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| Online Access: | https://doi.org/10.1002/cdt3.104 |
| _version_ | 1797276733667278848 |
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| author | Yongze Zhuang Hailing Lu Junxia Li |
| author_facet | Yongze Zhuang Hailing Lu Junxia Li |
| author_sort | Yongze Zhuang |
| collection | DOAJ |
| description | Abstract Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease, and the “four‐hit” theory represents its currently accepted pathogenic mechanism. Mucosal immunity triggered by infections in the respiratory tract, intestines, or other areas leads to antigen presentation, T cell stimulation, B cell maturation, and the production of IgA‐producing plasma cells. The proteins B‐lymphocyte stimulator (BLyS) and a proliferation‐inducing ligand (APRIL) are involved in this process, and alternative complement and lectin pathway activation are also part of the pathogenic mechanism. Kidney Disease Improving Global Outcomes guidelines indicate that a specific effective treatment for IgAN is lacking, with renin–angiotensin–aldosterone system inhibitors being the primary therapy. Recent research shows that biological agents can significantly reduce proteinuria, stabilize the estimated glomerular filtration rate, and reverse some pathological changes, such as endocapillary proliferation and crescent formation. There are four main categories of biological agents used to treat IgA nephropathy, specifically anti‐CD20 monoclonal antibodies, anti‐BLyS or APRIL monoclonal antibodies, monoclonal antibodies targeting both BLyS and APRIL (telitacicept and atacicept), and monoclonal antibodies inhibiting complement system activation (narsoplimab and eculizumab). However, further research on the dosages, treatment duration, long‐term efficacy, and safety of these biological agents is required. |
| first_indexed | 2024-03-07T15:32:26Z |
| format | Article |
| id | doaj.art-3ccc8c22f38e40bbaaadbdc645c4d0a4 |
| institution | Directory Open Access Journal |
| issn | 2589-0514 |
| language | English |
| last_indexed | 2024-03-07T15:32:26Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Chronic Diseases and Translational Medicine |
| spelling | doaj.art-3ccc8c22f38e40bbaaadbdc645c4d0a42024-03-05T15:35:59ZengWileyChronic Diseases and Translational Medicine2589-05142024-03-0110111110.1002/cdt3.104Advances in the treatment of IgA nephropathy with biological agentsYongze Zhuang0Hailing Lu1Junxia Li2Department of Nephrology, 900 Hospital of the Joint Logistics Team, PLA, Fuzhou General Clinical Medical College Fujian Medical University Fuzhou Fujian ChinaDepartment of Nephrology, 900 Hospital of the Joint Logistics Team, PLA, Fuzhou General Clinical Medical College Fujian Medical University Fuzhou Fujian ChinaDepartment of Nephrology, 900 Hospital of the Joint Logistics Team, PLA, Fuzhou General Clinical Medical College Fujian Medical University Fuzhou Fujian ChinaAbstract Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease, and the “four‐hit” theory represents its currently accepted pathogenic mechanism. Mucosal immunity triggered by infections in the respiratory tract, intestines, or other areas leads to antigen presentation, T cell stimulation, B cell maturation, and the production of IgA‐producing plasma cells. The proteins B‐lymphocyte stimulator (BLyS) and a proliferation‐inducing ligand (APRIL) are involved in this process, and alternative complement and lectin pathway activation are also part of the pathogenic mechanism. Kidney Disease Improving Global Outcomes guidelines indicate that a specific effective treatment for IgAN is lacking, with renin–angiotensin–aldosterone system inhibitors being the primary therapy. Recent research shows that biological agents can significantly reduce proteinuria, stabilize the estimated glomerular filtration rate, and reverse some pathological changes, such as endocapillary proliferation and crescent formation. There are four main categories of biological agents used to treat IgA nephropathy, specifically anti‐CD20 monoclonal antibodies, anti‐BLyS or APRIL monoclonal antibodies, monoclonal antibodies targeting both BLyS and APRIL (telitacicept and atacicept), and monoclonal antibodies inhibiting complement system activation (narsoplimab and eculizumab). However, further research on the dosages, treatment duration, long‐term efficacy, and safety of these biological agents is required.https://doi.org/10.1002/cdt3.104anti‐CD20 monoclonal antibodiesAPRILbiological agentsBLyScomplementIgA nephropathy |
| spellingShingle | Yongze Zhuang Hailing Lu Junxia Li Advances in the treatment of IgA nephropathy with biological agents Chronic Diseases and Translational Medicine anti‐CD20 monoclonal antibodies APRIL biological agents BLyS complement IgA nephropathy |
| title | Advances in the treatment of IgA nephropathy with biological agents |
| title_full | Advances in the treatment of IgA nephropathy with biological agents |
| title_fullStr | Advances in the treatment of IgA nephropathy with biological agents |
| title_full_unstemmed | Advances in the treatment of IgA nephropathy with biological agents |
| title_short | Advances in the treatment of IgA nephropathy with biological agents |
| title_sort | advances in the treatment of iga nephropathy with biological agents |
| topic | anti‐CD20 monoclonal antibodies APRIL biological agents BLyS complement IgA nephropathy |
| url | https://doi.org/10.1002/cdt3.104 |
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