Renal & ocular targets for therapy in Wegener's granulomatosis.
Wegener's granulomatosis (WG) is a multisystem small-vessel vasculitis which is characterised by granulomatous inflammation. Respiratory tract involvement is most commonly seen, affecting up to 85% of patients, closely followed by the renal system in up to 75% of patients; ocular involvement in WG is estimated to occur in 50-60% of patients. The purpose of this review is to provide an overview of the renal and ocular manifestations of WG and discuss the rationale behind the therapeutic approach. In particular, we will focus on how understanding the disease processes in both of these organs has led to more targeted therapy. The mechanism of action of the various immunosuppressive medications in both systemic and ocular inflammation and the evidence available for their use will also be discussed.
Joshi
Lavnish
L
Multidisciplinary Vasculitis Clinic, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
Hamour
Sally
S
Salama
Alan D
AD
Pusey
Charles D
CD
Lightman
Sue
S
Taylor
Simon R J
SR
D000818:Animals; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000937:Antigen-Antibody Reactions; D018951:Antigens, CD20 / Q000276:immunology*; D015551:Autoimmunity / Q000276:immunology; D003520:Cyclophosphamide / Q000627:therapeutic use; D005921:Glomerulonephritis; D014890:Granulomatosis with Polyangiitis / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007165:Immunosuppression Therapy; D011239:Prednisolone / Q000627:therapeutic use; D000069283:Rituximab; D015423:Scleritis; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D014657:Vasculitis
D019268:Antibodies, Antineutrophil Cytoplasmic; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D003520:Cyclophosphamide; D011239:Prednisolone