New diagnostic tests and new therapies for glomerular diseases.
There has recently been considerable progress in our understanding of the pathology and mechanisms of a number of primary glomerulopathies. However, without parallel advancement in both our diagnostic skills and treatment methods, such advances cannot be translated into clinical progress. Fortunately, a number of new promising diagnostic tests are being evaluated in patients with a variety of primary glomerulopathies including focal segmental glomerulosclerosis membranous nephropathy, IgA nephropathy, and C3 glomerulopathies. Likewise, a number of new therapeutic interventions are available to treat these entities, including the pituitary hormone ACTH, the monoclonal antibody rituximab, and the monoclonal blocker of the fifth component of complement, eculizumab. All three are already FDA-approved for at least one glomerular disease. This article will discuss these newer diagnostic tests and therapies as well as their potential roles in patients with glomerular diseases and where they fit in with the rest of our therapeutic armamentarium in treating patients with glomerular diseases.
Glomerular Kidney Disease Center, Division of Nephrology, Columbia University Medical Center, and College of Physicians and Surgeons, Columbia University, New York, NY, USA. gba2@columbia.edu
Gerald B
GB
Appel
Alice Sue
AS
Appel
D000324:Adrenocorticotropic Hormone / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000494:pharmacology / Q000627:therapeutic use; D003955:Diagnostic Tests, Routine; D005921:Glomerulonephritis / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007678:Kidney Glomerulus / Q000187:drug effects / Q000473:pathology; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D000069283:Rituximab
D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D000324:Adrenocorticotropic Hormone; C481642:eculizumab