RESUMEN
Uncontrolled complement activation can cause or contribute to glomerular injury in multiple kidney diseases. Although complement activation plays a causal role in atypical hemolytic uremic syndrome and C3 glomerulopathy, over the past decade, a rapidly accumulating body of evidence has shown a role for complement activation in multiple other kidney diseases, including diabetic nephropathy and several glomerulonephritides. The number of available complement inhibitor therapies has also increased during the same period. In 2022, Kidney Diseases: Improving Global Outcomes (KDIGO) convened a Controversies Conference, "The Role of Complement in Kidney Disease," to address the expanding role of complement dysregulation in the pathophysiology, diagnosis, and management of various glomerular diseases, diabetic nephropathy, and other forms of hemolytic uremic syndrome. Conference participants reviewed the evidence for complement playing a primary causal or secondary role in progression for several disease states and considered how evidence of complement involvement might inform management. Participating patients with various complement-mediated diseases and caregivers described concerns related to life planning, implications surrounding genetic testing, and the need for inclusive implementation of effective novel therapies into clinical practice. The value of biomarkers in monitoring disease course and the role of the glomerular microenvironment in complement response were examined, and key gaps in knowledge and research priorities were identified.
Asunto(s)
Activación de Complemento , Humanos , Activación de Complemento/inmunología , Inactivadores del Complemento/uso terapéutico , Proteínas del Sistema Complemento/inmunología , Proteínas del Sistema Complemento/metabolismo , Biomarcadores/sangre , Síndrome Hemolítico Urémico Atípico/inmunología , Síndrome Hemolítico Urémico Atípico/terapia , Síndrome Hemolítico Urémico Atípico/diagnóstico , Glomerulonefritis/inmunología , Glomerulonefritis/terapia , Glomerulonefritis/diagnóstico , Progresión de la Enfermedad , Nefropatías Diabéticas/inmunología , Nefropatías Diabéticas/diagnóstico , Nefropatías Diabéticas/etiología , Nefropatías Diabéticas/terapia , Congresos como Asunto , Glomérulos Renales/inmunología , Glomérulos Renales/patología , Enfermedades Renales/inmunología , Enfermedades Renales/terapia , Enfermedades Renales/diagnósticoRESUMEN
Our ability to integrate posture with visually demanding tasks is a critical aspect of motor behavior flexibility. When looking at a small object, excessive body movements impair an individual's ability to visually attend to the object. To overcome this problem, we adjust our postural sway to successfully focus on the object. The goal of the current study was to assess whether infants also adjust postural sway when engaged in a challenging visual task. The participants, 19 independently sitting infants (Sitters) and 21 newly independently standing infants (Standers), sat or stood on a force plate while viewing differently sized images displayed on a monitor (smaller images: 8 × 6.5 cm or 3 × 3 cm; larger images: 13 × 16 cm or 13 × 13 cm). Regardless of image size, Standers were less stable than Sitters with larger sway areas and faster sway velocities. Both Sitters and Standers adjusted sway area but not sway velocity, based on image size. Sitters and Standers differed in how they controlled sway dynamics. Standers but not Sitters altered sway dynamics based on image size. Overall, infants used posture-specific adaptive control strategies to make fine-grained adjustments based on image size. The development of the ability to integrate posture with a visually demanding task further emphasizes the capability of advanced complex motor behaviors during infancy, enabling infants to flexibly attend to important aspects of their environment at different postural positions.