title: Emerging therapies in immunoglobulin A nephropathy.
abstract: Despite advances in our understanding of immunoglobulin A nephropathy (IgAN) over the past decade, there are currently no specific therapies capable of targeting key pathways involved in the pathogenesis of the disease. Recent studies have, however, provided new insights into important molecular pathways that are likely to be amenable to therapeutic manipulation in the future. Specifically, a deeper understanding of the role of mucosal immunity, B-cell activation and mesangial cell activation in IgAN has provided the impetus for a number of exciting phase II/III clinical trials in IgAN. In this review, we examine some of these on-going studies, first examining studies that clarify the role of traditional immunosuppression in IgAN, then focusing on novel therapies in early clinical studies, looking closely at the rationale for these agents in relation to our current understanding of the pathogenesis of IgAN. Finally, we examine emerging pathways and therapeutic agents that have the potential to be developed as novel therapies in the coming years. It is hoped that as we continue to develop a greater understanding of IgAN, emerging therapies will soon become a reality in the day-to-day treatment of patients with IgAN.
authors.affiliation: Department of Renal Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: See Cheng
authors.initials: SC
authors.lastname: Yeo
authors.affiliation: Department of Renal Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: Adrian
authors.initials: A
authors.lastname: Liew
authors.affiliation: Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.|The John Walls Renal Unit, Leicester General Hospital, Leicester, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Barratt
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D055808:Drug Discovery; D015507:Drugs, Investigational / Q000009:adverse effects / Q000627:therapeutic use*; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D015507:Drugs, Investigational; D007166:Immunosuppressive Agents
keywords: IgA nephropathy; clinical trial; immunosuppression; novel therapy