Complement inhibitors for kidney disease.
Complement inhibitors for kidney disease.
复制标题
补体抑制剂治疗肾脏疾病。
DOI：
10.1093/ndt/gfad079
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
A. Bomback
中科院分区：
文献类型：
--
作者：
Benjamin Wooden;Blanca Tarragon Estebanez;M. Navarro;A. Bomback
在过去的二十年里，随着补体靶向治疗的发展，对补体在肾小球和其他肾脏疾病发病机制中的作用有了更深入的了解。随着我们越来越认识到补体激活在所有三种途径中的重要作用-经典途径、凝集素途径和替代途径-在罕见的肾小球病变(例如C3肾小球病变)和常见的肾小球病变(例如IgA肾病)中发挥着重要作用，我们可以找到精确的、有针对性的方法来改变这些肾脏疾病的自然病史。在这篇综述中，我们综述了从最早的专注于C5靶向药物的小规模研究到最近的大型、多中心、随机试验，利用补体阻断在补体途径中更高的C3水平上使用补体抑制的证据。根据这些研究，我们总结了补体靶向治疗领域的发展方向。
A refined understanding of the role of complement in the pathogenesis of glomerular and other kidney diseases has, over the past two decades, been matched by the development of novel, complement targeting therapies. As we increasingly recognize the important role that complement activation across all three pathways-classical, lectin, and alternative-plays in glomerular lesions both rare (e.g. C3 glomerulopathy) and common (e.g. IgA nephropathy), we can identify avenues for precise, targeted approaches at modifying the natural history of these kidney diseases. In this review, we survey the evidence on using complement inhibition from the earliest, small-scale studies focusing on C5-targeting agents to more recent, large, multi-center, randomized trials utilizing complement blockade higher up in the complement pathway at the level of C3. We conclude by examining where the field of complement targeting therapy may be headed in light of these studies.