Treatment of lupus nephritis

Facing the era of immunotherapy

A. A. Aran, Chaim Putterman

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Lupus nephritis (LN) is a major cause of morbidity and mortality, affecting over half of SLE patients. The traditional treatment protocol with cyclophosphamide and corticosteroids dramatically improved patient and renal survival, but conferred a heavy burden of side effects. In addition, not all patients respond to first-line immunosuppression; 35% suffer at least one episode of renal relapse and 5-20% develop end-stage renal disease. Over the last decade, the increasing understanding of the complex pathogenesis underlying lupus nephritis and accelerating advances in molecular and cellular immunology have paved the way for development of immunomodulatory therapies for LN. In contrast to the global immunosuppressive effects of conventional treatment, these biologic agents target specific pathways that contribute to the inflammatory response, aiming to reduce tissue damage while preserving immunocompetence. The goal of this review is to highlight some of the more promising novel immunomodulators, including Abetimus sodium, Rituximab, Epratuzumab, Abatacept, Belimumab, Tocilizumab and Infliximab, and discuss how these agents affect central pathways in the pathogenesis of disease.

Original languageEnglish (US)
Pages (from-to)235-245
Number of pages11
JournalPanminerva Medica
Volume50
Issue number3
StatePublished - Sep 2008

Fingerprint

Lupus Nephritis
Immunotherapy
Kidney
Immunocompetence
Immunomodulation
Immunologic Factors
Biological Factors
Immunosuppressive Agents
Clinical Protocols
Allergy and Immunology
Cyclophosphamide
Immunosuppression
Chronic Kidney Failure
Adrenal Cortex Hormones
Therapeutics
Morbidity
Recurrence
Mortality

Keywords

  • B-lymphocytes
  • Immunotherapy
  • Lupus erythematosus, systemic
  • Lupus nephritis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Treatment of lupus nephritis : Facing the era of immunotherapy. / Aran, A. A.; Putterman, Chaim.

In: Panminerva Medica, Vol. 50, No. 3, 09.2008, p. 235-245.

Research output: Contribution to journalArticle

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