Rituximab in idiopathic nephrotic syndrome: does it make sense?
Rituximab in idiopathic nephrotic syndrome: does it make sense?
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利妥昔单抗治疗特发性肾病综合征：有意义吗？
DOI：
10.1007/s00467-013-2534-4
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Garin,EduardoH
中科院分区：
文献类型：
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作者：
Cara-Fuentes,Gabriel;Kairalla,JohnA;Ishimoto,Takuji;Rivard,Christopher;Johnson,RichardJ;Garin,EduardoH
特发性肾病综合征（INS）包括三种不同的疾病：微小病变（MCD）、局灶节段性肾小球硬化（FSGS）和系膜增生性肾小球肾炎。从历史上看，这种情况归因于T细胞疾病，导致分泌循环因子，增加肾小球对血浆蛋白的渗透性。控制INS蛋白尿的治疗方法仍然是使用被认为能抑制T细胞分泌的“循环因子”产生的药物。最近，利妥昔单抗（RTX），一种针对B细胞上表达的CD 20细胞表面受体的嵌合单克隆抗体，已经成为潜在的治疗剂。报告RTX治疗肾病综合征临床经验的出版物数量在过去几年中大幅增加。然而，目前没有来自临床或实验研究的良好证据支持RTX在治疗MCD和FSGS蛋白尿中的作用。总之，需要更好地了解INS蛋白尿的发病机制以及RTX在这种情况下的潜在作用。
Idiopathic nephrotic syndrome (INS) includes three different entities: minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and mesangial proliferative glomerulonephritis. Historically, this condition has been attributed to a T-cell disorder resulting in the secretion of a circulating factor that increases glomerular permeability to plasma proteins. The therapeutic approach to control the proteinuria of INS remains the use of drugs that have been considered to suppress the production of the “circulating factor” secreted by T cells. Recently, rituximab (RTX), a chimeric monoclonal antibody directed against the CD20 cell surface receptor expressed on B cells, has emerged as potential therapeutic agent. The number of publications reporting clinical experience with RTX in the treatment of nephrotic syndrome has greatly increased in the last few years. However, there is currently no good evidence from clinical or experimental studies that support a role of RTX in the treatment of MCD and FSGS proteinuria. In summary, there is the need for a better understanding of the pathogenesis of the proteinuria in INS and the potential role of RTX in this condition.