首页|Complement is Complimentary in Membranous Nephropathy
Complement is Complimentary in Membranous Nephropathy
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NSTL
Amer Soc Nephrology
The complement system provides an ancient, highly conserved, cascade of interacting proteins orchestrating innate and adaptive immune responses. In addition to protecting the host from infections, the complement contributes to the pathogenesis of various disorders, including kidney diseases.1 The exploration of complement-directed treatment strategies in these diseases, including several glomerulonephritides, makes eminent sense. ANCA vasculitis provides the latest example in which preclinical models implicated the complement as an important disease mediator and where the clinical application was not “lost in translation.” Experimental studies in cell and murine vasculitis models identified the interaction of the anaphylatoxin C5a with the activating C5a receptor-1 (C5aRl or CD88) as a central disease process. The human C5aR1 was then introduced into mice, allowing the development of a small molecule that blocked the human C5aRl.3 This complement-directed strategy was recently explored in a randomized controlled trial. The oral C5aR blocker, avacopan, was superior to prednisone taper with respect to sustained remission at 52 weeks. Avacopan is now on its way into routine clinical practice, and it will be our task to position this new tool within existing ANCA vasculitis treatments.
Ralph Kettritz、Adrian Schreiber
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Department of Nephrology and Medical Intensive Care, Charite-Universit?tsmedizin Berlin, corporate
NSTL
Amer Soc Nephrology
