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Cancer is a type of non-communicable disease that is responsible for numerous deaths worldwide. Cancer incidence and mortality rates are on the rise due to a combination of factors, such as a growing population, aging, and poor dietary habits. The Allium turcicum Özhatay & Cowley plant is an endemic plant in the area where it grows and is consumed by the public due to its various benefits. This endemic plant, which generally grows in high-altitude regions, is sold in bunches because it is costly, mixed with rock salt, crushed into powder, and consumed as a spice. The cytotoxic and growth-inhibitory effects of A. turcicum Özhatay & Cowley herb extract on human glioblastoma U373 cells, human colorectal carcinoma cell HCT-116, and healthy HUVEC cell lines were determined by the MTT method. After 24 and 48 h of application, logIC50 values in HUVEC, HCT-116, and U373 cells were defined as 3.737, 3.765; 3.513, 3.696, 4.476, and 4.104 µg/mL, respectively. We conducted a cell migration experiment to study the A. turcicum Özhatay & Cowley Extract (ATÖCE) impact on cancer cells' metastatic behavior. Our findings indicate that ATÖCE has an inhibitory effect on the migration potential of the cells used in the study. We conducted experiments using DPPH, ABTS, CUPRAC, and total phenolic content to assess the antioxidant properties of ATÖCE. The findings from the antioxidant activity experiments revealed an activity level of 0.20 ± 0.046 at IC50. Additionally, the total phenolic content was measured to be 0.26 ± 0.044 mg GAE/g.
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Introduction: The method of encapsulating the drug molecule in a carrier, such as a magnetic nanoparticle, is a promising development that has the potential to deliver the medicine to the site where it is intended to be administered. Morin is a pentahydroxyflavone obtained from the leaves, stems, and fruits of various plantsmainly from the Moraceae family exhibiting diverse pharmacological activities such as anti-inflammatory, anti-oxidant, and free radical scavenging and helps treat diseases such as diabetes, myocardial infarction and cancer. Methods: In this study, we conducted the synthesis of a nanocomposite with magnetic properties by coating biocompatible activated carbon obtained from okra plant leaves with magnetic nanoparticles. Results: Characterization of the synthesized activated carbon-coated magnetic nanocomposite was confirmed by Fourier transform infrared, scanning electron microscopy, dynamic light scattering, and zeta potential. The cytotoxic effects of the drug-loaded magnetic nanocomposite were examined in HT-29 (Colorectal), MCF-7 (breast), U373 (brain), T98-G (Glioblastoma) cancer cell lines, and human umbilical vein endothelial cells healthy cell line. Discussion: We studied the loading and release behavior of morin hydrate in the activated carbon-coated magnetic nanocomposite. Activated carbon-coated magnetic nanocomposite carriers can show promising results for the delivery of Morin hydrate drugs to the targeted site.
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Cardiorenal syndrome (CRS) is defined as a broad spectrum of conditions encompassing both the heart and kidneys in which acute or chronic heart disorder may induce acute or chronic tubular injury in the kidneys and vice versa. Early diagnosis allows timely intervention and attenuates disease progression. Two well-established biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) and brain (B-type) natriuretic peptide (BNP), are reflective of impaired cardiac and kidney function associated with poor prognosis in various cardiac disorders, including heart failure and coronary artery disease. Given the ongoing contribution of CRS to the high morbidity and mortality post-MI, early risk stratification and preventive measures are highly significant. In this review, we examine Surface Plasmon Resonance (SPR) optical biosensors for detection of these biomarkers and discuss potential implications of this highly sensitive and specific technology in CRS detection, treatment and outcomes.
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Técnicas Biossensoriais , Síndrome Cardiorrenal , Ressonância de Plasmônio de Superfície , Humanos , Síndrome Cardiorrenal/diagnóstico , Síndrome Cardiorrenal/sangue , Técnicas Biossensoriais/métodos , Biomarcadores/análise , Biomarcadores/sangue , Lipocalina-2/análise , Peptídeo Natriurético Encefálico/sangue , Peptídeo Natriurético Encefálico/análiseRESUMO
BACKGROUND: Diabetic nephropathy (DN) is a common complication of type 2 diabetes (T2D). Chronic inflammation and a combination of environmental and genetic factors are involved in the pathogenesis and development of DN. OBJECTIVE: This case-control study aimed to determine the relationship between rs7529229 and rs2228145 polymorphisms of the IL-6R gene with the incidence of nephropathy among T2D patients. METHODS: Fifty-six diabetic patients with nephropathy and 57 T2D patients without nephropathy were included based on inclusion criteria, along with 150 healthy individuals. METHODS: Fifty-six diabetic patients with nephropathy and 57 T2D patients without nephropathy were included based on inclusion criteria, along with 150 healthy individuals. RESULTS: The frequencies of AC and CC genotype distributions of the rs2228145 polymorphism in DN patients were significantly higher than in healthy individuals (24.1 and 9.3% versus 10.7 and 6.7%, respectively, P= 0.02). Moreover, the frequency of allele C was higher in DN patients compared to healthy controls (21.30% versus 12%, P=0.025). However, genotype distribution and allele frequencies of the rs7529229 IL-6R polymorphism in DN patients were not statistically significant in comparison with diabetic patients and healthy individuals (P> 0.05). CONCLUSION: The results showed that the allele and genotype distribution frequencies of rs2228145 IL-6R gene polymorphism in patients with DN were significantly higher than in healthy individuals. Therefore, the presence of this polymorphism may be involved in the development of diabetic nephropathy in this population.
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BACKGROUND: Prostate cancer is among the most common cancers in men with an increasing incidence rate. Radiation therapy (RT) is a therapeutic strategy for the management of prostate cancer after surgery; nonetheless, it has different side effects on neighboring healthy cells/tissues. Moreover, radioresistance has been an increasing phenomenon in the recent years. Therefore, there is an urgent need for the introduction of a safe and effective radiosensitizing agent. Accordingly, the recent trend in the development of novel drugs is accompanied by a push toward natural compounds. Our study evaluated the effects of betanin combined with RT as a potential radiosensitizing agent in the PC-3 cell line. METHODS AND RESULTS: MTT assay was utilized to determine the growth inhibitory impact of betanin. The possible synergistic effect was evaluated with CompuSyn software upon Trypan blue exclusion test. Apoptosis-related gene expression was evaluated via Real-time PCR and the protein expression of P21 was determined using western blotting. A synergistic anticancer effect with an optimal combination index of 0.61 was achieved by treating PC-3 cells with betanin and RT. The results pointed out that betanin synergistically triggered RT-mediated apoptosis and cell cycle arrest through modulating gene and protein expression in comparison with each of the monotherapies. CONCLUSION: These findings shed light on the synergistic antitumor effect of betanin and RT in prostate cancer, indicating the potential use of betanin as a radiosensitizer agent.
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Neoplasias da Próstata , Radiossensibilizantes , Masculino , Humanos , Betacianinas/farmacologia , Betacianinas/uso terapêutico , Linhagem Celular Tumoral , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/metabolismo , Apoptose , Radiossensibilizantes/farmacologiaRESUMO
During the development of nanotechnology, the production of many substances containing nanoparticles leads to the release of various nanoparticles into the environment, including the water ecosystem. The main goal of the current research was to study the ultrastructural characteristics of the entry and bioaccumulation of Fe3O4 nanoparticles in the small intestine of Cyprinus carpio (Linnaeus, 1758), as well as the pathomorphological changes in the fish organism. Two different doses (10 and 100 mg) of Fe3O4 nanoparticles were fed to fingerlings for 7 days and then intestinal samples were taken and studied. It was found that the extent of damages was boosted within the increment of nanoparticle concentration. The sequence and bioaccumulation of Fe3O4 nanoparticles in the small intestine of fish occurred as below: firstly, the nanoparticles passed into microvilli located in the apical part of enterocytes in the mucosa layer, from there into the cytoplasm of the epithelial cells, including cytoplasmatic organelles (nucleus, mitochondria, lysosomes, fat granules), and then into a lamina propria of the mucosa of the small intestine and passed into the endothelium of the blood vessels and to the erythrocytes of the vessels which located in the lumen. It was determined that although the nanoparticles were up to 30 nm in size, only particles with a maximum size of 20 nm could penetrate the intestinal wall. Thus, the release of Fe3O4 nanoparticles into the environment in high doses has a negative effect on the living ecosystem, including the body of fish living in the water.
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Carpas , Nanopartículas , Animais , Ecossistema , Intestinos , Lisossomos , Aquicultura , Ferro , Nanopartículas/toxicidadeRESUMO
Purpose: Calcineurin inhibitors (CNIs) such as tacrolimus are a major immunosuppressive therapy after renal transplantation, which inhibit cytokine expression. The pharmacokinetics of such drugs is influenced by cytochrome P450 (CYP) enzymes, multi-drug resistance-1 (MDR-1), and C25385T pregnane X receptor (PXR). This study aimed to investigate the impact of single nucleotide polymorphisms (SNP) in these genes on the ratio of tacrolimus level per drug dosage (C/D ratio), acute graft rejection, and viral infections. Methods: Kidney transplantation recipients (n=65) under similar immunosuppressive treatment were included. Amplification refractory mutation systempolymerase chain reaction (ARMS-PCR) method was applied to amplify the loci containing the SNPs of interest. Results: Overall, 65 patients with a male/female ratio of 37/28 were included. The mean age was 38±1.75 years. The variant allele frequencies of CYP3A5*3, MDR-1 C3435T, and PXR C25385T were 95.38, 20.77, and 26.92%, respectively. No significant correlations were found between the studied SNPs and the tacrolimus C/D ratios. However, there was a significant difference in the C/D ratios at 2 and 8 weeks in homozygote CYP3A5 *3/*3 carriers (P=0.015). No significant association was found between the studied polymorphisms and viral infections and acute graft rejection (P>0.05). Conclusion: Homozygote CYP3A5 *3/*3 genotype could influence the tacrolimus metabolism rate (C/D ratio).
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Nanomaterials have been extensively studied in cancer therapy as vectors that may improve drug delivery. Such vectors not only bring numerous advantages such as stability, biocompatibility, and cellular uptake but have also been shown to overcome some cancer-related resistances. Nanocarrier can deliver the drug more precisely to the specific organ while improving its pharmacokinetics, thereby avoiding secondary adverse effects on the not target tissue. Between these nanovectors, diverse material types can be discerned, such as liposomes, dendrimers, carbon nanostructures, nanoparticles, nanowires, etc., each of which offers different opportunities for cancer therapy. In this review, a broad spectrum of nanovectors is analyzed for application in multimodal cancer therapy and diagnostics in terms of mode of action and pharmacokinetics. Advantages and inconveniences of promising nanovectors, including gold nanostructures, SPIONs, semiconducting quantum dots, various nanostructures, phospholipid-based liposomes, dendrimers, polymeric micelles, extracellular and exome vesicles are summarized. The article is concluded with a future outlook on this promising field.
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Dendrímeros , Nanopartículas , Neoplasias , Humanos , Lipossomos , Sistemas de Liberação de Medicamentos , Nanopartículas/química , Neoplasias/tratamento farmacológicoRESUMO
The use of medicinal plants has grown in popularity in recent decades because, as natural ingredients, they have fewer adverse effects and are more effective than synthetic alternatives. As a small perennial herb, Glycyrrhiza glabra L. (Licorice) has been investigated for its therapeutic efficacy against neural disorders mainly ischemic stroke as well as the neurodegenerative diseases such as dementia and Alzheimer's disease, and Parkinson's disease which has been attributed to its HMGB inhibitory function, reactive oxygen scavenging and anti-inflammatory activity. The objective of current review is to review the evidence for the pharmacological effects of licorice and its vital active components on neurological disorders and the underlying signaling networks. We reviewed Papers published from 2000.1.1 up to 2 January 2023 in web of science, Google Scholar and PubMed data bases using key words including "Licorice," "Glycyrrhiza glabra L.," "Glycyrrhizic acid," "brain," "neurodegenerative disease," "Alzheimer's," and "Parkinson" were used to search in title/abstracts. Licorice extract and/or its active components can be used safely in therapeutic doses for optimizing the management of a multiple neurodegenerative disorders, and hampering the extent of neural tissue injury and neurologic deficits subsequent to cerebrovascular accidents.
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Kidney ischemia/reperfusion (I/R) injury is a leading cause of acute kidney injury (AKI) occurring frequently under major surgeries and sepsis. This study aimed to evaluate the effect of Eprosartan, an angiotensin II receptor type-1 (AT-1) antagonist, on the kidney I/R rat model. Male Wistar rats (n = 24) were allocated into (i) Sham, (ii) Eprosartan, (iii) I/R, and (iv) Eprosartan + I/R groups. Animals in the last group received a single dose of Eprosartan (60 mg/kg) 1 h before kidney I/R. Renal oxidant/antioxidant, inflammatory (NF-κB p65, COX-2, IL-6, TNF-α), and apoptotic (caspase-3, Bax, Bcl2) factors along with Sirtuin 1, Klotho, and mitochondrial biogenesis (PGC-1α, and Sirtuin 3) factors were evaluated by Western blotting. Significant recovery of kidney function and increased levels of antioxidant markers were observed in the Eprosartan + I/R group. The Eprosartan anti-inflammatory activity was demonstrated by significant downregulation of NF-κB and its downstream pro-inflammatory factors. Eprosartan pretreatment could also abolish I/R-induced alterations in the apoptotic parameters. Moreover, Eprosartan + I/R rats significantly presented higher levels of Sirtuin 1 content. In conclusion, Eprosartan exhibited nephroprotective effects against kidney damage induced by I/R in rats by decreasing oxidative stress, inflammatory, and apoptotic pathways along with increasing Sirtuin1 level.
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Injúria Renal Aguda , Traumatismo por Reperfusão , Ratos , Masculino , Animais , NF-kappa B/metabolismo , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Antioxidantes/metabolismo , Caspase 3/metabolismo , Sirtuína 1/metabolismo , Ratos Wistar , Rim , Injúria Renal Aguda/metabolismo , Traumatismo por Reperfusão/metabolismo , Isquemia/metabolismoRESUMO
Articular cartilage has a low self-repair capacity due to the lack of vessels and nerves. In recent times, nanofiber scaffolds have been widely used for this purpose. The optimum nanofiber scaffold should stimulate new tissue's growth and mimic the articular cartilage nature. Furthermore, the characteristics of the scaffold should match those of the cellular matrix components of the native tissue to best merge with the target tissue. Therefore, selective modification of prefabricated scaffolds based on the structure of the repaired tissues is commonly conducted to promote restoring the tissue. A thorough analysis is required to find out the architectural features of scaffolds that are essential to make the treatment successful. The current review aims to target this challenge. The article highlights different optimization approaches of nanofibrous scaffolds for improved cartilage tissue engineering. In this context, the influence of the architecture of nanoscaffolds on performance is discussed in detail. Finally, based on the gathered information, a future outlook is provided to catalyze development in this promising field.
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Cartilagem Articular , Nanofibras , Cartilagem Articular/fisiologia , Alicerces Teciduais/química , Engenharia Tecidual , Matriz ExtracelularRESUMO
Renal injury and the development of albuminuria are tightly connected with the loss of podocytes. Podocyte damages cause proteinuric renal diseases since podocyte foot processes (FP) and their interposed slit diaphragms (SD) are the final barriers against protein loss. Podocyte effacement and the resultant deterioration of podocyte SD integrity that involve the active rearrangement of the podocyte actin cytoskeleton is a chief mechanism of proteinuric kidney diseases. The progress of these injuries can eventually lead to cell detachment and death. Due to the prominence of the actin cytoskeleton in maintaining glomerular filtration, the assessment of the molecular design and regulation of actin is a central target of podocyte research. In the current review, a comprehensive summary of the actin cytoskeleton, its constituents, and regulatory signaling pathways has been provided. Since actin-regulated cell plasticity is a crucial feature of normal podocyte function, and deteriorations in its dynamics seem to directly affect podocyte morphology and glomerular permeability, this review discusses cascades that regulate actin polymerization in podocytes.
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Actinas , Podócitos , Citoesqueleto de Actina , Glomérulos Renais , Junções IntercelularesRESUMO
In recent years, the comprehensive analysis of saliva, i.e., salivaomics, has played an increasing role in biomarker discovery for disease detection in general and cancer specifically. Saliva is a readily accessible, non-invasive and low-cost specimen that can be used to detect biomarkers of clinical relevance. Saliva-based "omics" technologies, which include proteomics, transcriptomics, metabolomics and microbiomics, have rapidly evolved and may be applicable in point-of-care detection, liquid biopsy and nanoscience. Advances in analytical methods has increased the scope and application of salivaomics from solely the oral cavity to the entire physiologic system, and accordingly to personalized medicine. In this chapter, we highlight recent advances in analytical approaches to identify and detect biomarkers in saliva and their potential use as diagnostic, prognostic and therapeutic markers with a focus on cancer.
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Neoplasias , Biomarcadores/análise , Biomarcadores Tumorais/análise , Humanos , Metabolômica/métodos , Neoplasias/diagnóstico , Proteômica/métodos , Saliva/químicaRESUMO
A biodegradable micro/nano-structured porous hemostatic gelatin-based sponge as a dentistry surgery foam was prepared using a freeze-drying method. In vitro function evaluation tests were performed to ensure its hemostatic effect. Biocompatibility tests were also performed to show the compatibility of the sponge on human fetal foreskin fibroblasts (HFFF2) cells and red blood cells (RBCs). Then, 10 patients who required the extraction of two teeth were selected, and after teeth extraction, for dressing, the produced sponge was placed in one of the extracavities while a commercial sponge was placed in the cavity in the other tooth as a control. The total weight of the absorbed blood in each group was compared. The results showed a porous structure with micrometric and nanometric pores, flexibility, a two-week range for degradation, and an ability to absorb blood 35 times its weight in vitro. The prepared sponge showed lower blood clotting times (BCTs) (243.33 ± 2.35 s) and a lower blood clotting index (BCI) (10.67 ± 0.004%) compared to two commercial sponges that displayed its ability for faster coagulation and good hemostatic function. It also had no toxic effects on the HFFF2 cells and RBCs. The clinical assessment showed a better ability of blood absorption for the produced sponge (p-value = 0.0015). The sponge is recommended for use in dental surgeries because of its outstanding abilities.
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COVID-19 , Transtornos Mentais , Humanos , Transtornos Mentais/terapia , SARS-CoV-2 , Mudança SocialRESUMO
Glomerular injury is the major cause of chronic kidney diseases (CKD) worldwide and is characterized by proteinuria. Glomerulonephritis (GN) has a wide spectrum of etiologies, the intensity of glomerular damage, histopathology, and clinical outcomes that can be associated with the landscape of the nephritogenic immune response. Beyond impaired immune responses and genetic factors, recent evidence indicates that microbiota can be contributed to the pathogenesis of GN and patients' outcomes by impacting many aspects of the innate and adaptive immune systems. It is still unknown whether dysbiosis induces GN or it is a secondary effect of the disease. Several factors such as drugs and nutritional problems can lead to dysbiosis in GN patients. It has been postulated that gut dysbiosis activates immune responses, promotes a state of systemic inflammation, and produces uremic toxins contributing to kidney tissue inflammation, apoptosis, and subsequent proteinuric nephropathy. In this review, the impact of gastrointestinal tract (GI) microbiota on the pathogenesis of the primary GN will be highlighted. The application of therapeutic interventions based on the manipulation of gut microbiota with special diets and probiotic supplementation can be effective in GN.
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Glomerulonefrite , Microbiota , Insuficiência Renal Crônica , Humanos , Disbiose/complicações , Glomerulonefrite/etiologia , Insuficiência Renal Crônica/complicações , Inflamação/complicaçõesRESUMO
Liver and pancreatic tumors are among the third leading causes of cancer-associated death worldwide. In addition to poor prognosis, both cancer types are diagnosed at advanced and metastatic stages without typical prior symptoms. Unfortunately, the existing theranostic approaches are inefficient in cancer diagnosis and treatment. Carbon nanotubes (CNTs) have attracted increasing attention in this context due to their distinct properties, including variable functionalization capability, biocompatibility, and excellent thermodynamic and optical features. As a consequence, they are now regarded as one of the most promising materials for this application. The current review aims to summarize and discuss the role of CNT in pancreatic and liver cancer theranostics. Accordingly, the breakthroughs achieved so far are classified based on the cancer type and analyzed in detail. The most feasible tactics utilizing CNT-based solutions for both cancer diagnosis and treatment are presented from the biomedical point of view. Finally, a future outlook is provided, which anticipates how the R&D community can build on the already developed methodologies and the subsequent biological responses of the pancreatic and liver cancer cells to the directed procedures.
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Neoplasias Hepáticas , Nanotubos de Carbono , Humanos , Neoplasias Hepáticas/diagnóstico , PâncreasRESUMO
Acute kidney injury (AKI) is a major medical challenge caused from renal ischemia-reperfusion (IR) injury connected with different cellular events in other distant organs. Renal IR-related oxidative stress and inflammation followed by cell apoptosis play a crucial role in IR-induced distant organ pathological damages. Prazosin has shown protective effects against IR-injuries. Thus, the current study intended to investigate the possible protective role of prazosin against the consequents of renal IR in the heart and brain tissues. To reach this goal, rats were randomly divided into 3 groups (n=7): Sham, IR and prazosin pretreatment-IR animals (1 mg/kg intraperitoneally injection of prazosin 45 min before IR induction). After 6 h reperfusion, lipid peroxidation and antioxidant markers levels were evaluated in the both, brain and heart tissue. Moreover, apoptotic pathway in the heart and brain tissues were assessed by western blotting. Accordingly, prazosin pretreatment in IR model rats could significantly increase the antioxidant capacity and attenuate apoptotic pathways by increasing the bcl-2 levels and decreasing the expression of Bax and caspase 3 enzymes (P<0.05). Thus, prazosin suppressed cellular damages of heart and brain tissues post kidney IR by anti-oxidative and anti-apoptotic effects, which suggests the plausible use of prazosin in improving the clinical outcomes during AKI after further investigations.
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Injúria Renal Aguda , Traumatismo por Reperfusão , Injúria Renal Aguda/patologia , Animais , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Apoptose , Encéfalo/metabolismo , Isquemia/complicações , Isquemia/metabolismo , Isquemia/patologia , Rim , Estresse Oxidativo , Prazosina/farmacologia , Prazosina/uso terapêutico , Ratos , Reperfusão/efeitos adversos , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/prevenção & controleRESUMO
The present study aimed to systematically review the available investigations about the effects of okra on important inflammatory mediators including C-reactive protein (CRP), interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Electronic databases such as PubMed, Scopus, WOS, ProQuest, and the search engine Google Scholar were searched until August 2021 and search alerts were activated in order to notice papers issued after the initial search. There was no restriction in the date and/or language. No human research was found; therefore, animal and in vitro studies were considered. Also, the citations or references of these studies were assessed to gain possible research. Review papers, book chapters, and grey literature such as conference papers, dissertations, and patents were not considered. Twenty-six papers were considered in the systematic review. The concentrations of inflammatory mediators including CRP, IL-1ß, IL-6, and TNF-α mainly showed a downward trend after treatment with okra. In other words, the pooled direction of impacts was consistently lower for all of the evaluated inflammatory markers in the majority of preclinical (7 of 13 in vitro and 13 of 16 animal) studies. The findings proposed the potential of okra to lower CRP, IL-1ß, IL-6, and TNF-α. Okra is a promising but not yet confirmed natural ingredient to decrease systemic inflammation in patients with inflammation-predisposed diseases. Further research is needed to focus on evaluating the effects of okra on inflammatory mediators with lower variability as well as the clinical outcomes of inflammation-related diseases in order to add sufficient power to the results of this study.
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Abelmoschus , Anti-Inflamatórios/farmacologia , Proteína C-Reativa/análise , Citocinas/sangue , Mediadores da Inflamação/análise , Extratos Vegetais/farmacologia , Animais , Inflamação/tratamento farmacológicoRESUMO
The conventional treatment options (including alkylating agents, steroids, calcinurine inhibitors) have been largely replaced by anti-CD20 antibodies to achieve remission of nephrotic proteinuria in primary membranous nephropathy (PMN) patients. Two-third of rituximab-receiving PMN patients develop remission of proteinuria, and the results of MENTOR trial turned this drug into the first-line therapeutic agent in non-severe cases. However, in 20-40% of patients, remission is not achieved. Therefore, rituximab-resistant membranous nephropathy cases are increasingly reported. Different molecular mechanisms have been implicated in this context resulting in the introduction of new biologic agents. Second-generation anti-CD20 antibodies and other options such as plasma cell depleting agents and proteasome inhibition might lead to a novel treatment paradigm for patients with PMN.