Immunoadsorption in Autoimmune Diseases Affecting the Kidney.
Semin Nephrol
; 37(5): 478-487, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28863794
ABSTRACT
Autoantibodies play an important role in the pathophysiology of renal involvement in systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), systemic vasculitis, and anti-glomerular basement membrane disease (or Goodpasture syndrome). Direct removal of autoantibodies therefore has been tried in various ways, first by plasma exchange. Today, immunoadsorption is the extracorporeal method that most effectively removes (pathogenic) immune complexes and antibodies. Although past data have shown efficacy and biocompatibility of immunoadsorption in (renal) SLE, it is still an experimental and expensive procedure, and evidence from randomized controlled trials is needed. Nevertheless, immunoadsorption is being used as a rescue therapy in life-threatening situations of SLE patients because of its fast mode of action and its acceptable safety profile. In granulomatosis with polyangiitis (GPA) (or Wegener's granulomatosis), microscopic polyangiitis (MPA), and anti-glomerular basement membrane disease, the current standard is plasma exchange. Immunoadsorption, which probably would reduce the autoantibody burden more effectively, might be an even better more effective option, but sufficient evidence is lacking.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Técnicas de Imunoadsorção
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Doença Antimembrana Basal Glomerular
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Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos
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Lúpus Eritematoso Sistêmico
Tipo de estudo:
Clinical_trials
Limite:
Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article