title: Monoclonal antibodies for renal diseases: current concepts and ongoing treatments.
abstract: BACKGROUND
  In recent years, technological innovations in the field of molecular biology have provided new therapeutic options. In particular, human monoclonal antibodies (mAbs), initially used in the treatment of malignancies, have become a therapeutic tool for many other diseases. Most of the application of mAbs revealed encouraging findings to treat patients with immune-mediated glomerular diseases, for whom the standard protocols based on corticosteroids and non-specific immunosuppressants with heavy side effects have for decades been the only therapies.
  
  
  METHODS
  Rituximab, an mAb directed against a specific antigen expressed on B lymphocytes, CD20 antigen, inducing a premature cell apoptosis became very important in the treatment of membranous glomerulonephritis, steroid-resistant nephrotic syndromes and membranoproliferative glomerulonephritis (MPGN). Another important mAb, eculizumab, is used successfully for treatment of atypical hemolytic uremic syndrome, C3 nephropathy and MPGN. Many other mAbs are now under premarketing investigation, such as adalimumab, daclizumab, fresolimumab, belimumab, tocilizumab, although some of these mAbs are already approved for different medical applications.
  
  
  CONCLUSIONS
  The availability of novel mAb may therefore constitute the basis for a revolution in the treatment of immune-mediated renal diseases. However, the cost for this therapy remains very high and represents a barrier for its widespread use.
authors.affiliation: University of Messina, Department of Internal Medicine and Pharmacology , AOU G.Martino PAD C; Via Consolare Valeria, 98100 Messina , Italy +39 090 2212331 ; +39 090 2212331 ; santisi@hotmail.com.
authors.forename: Domenico
authors.initials: D
authors.lastname: Santoro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pellicanò
authors.forename: Luca
authors.initials: L
authors.lastname: Visconti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Trifirò
authors.forename: Valeria
authors.initials: V
authors.lastname: Cernaro
authors.forename: Michele
authors.initials: M
authors.lastname: Buemi
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000276:immunology / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology; D002986:Clinical Trials as Topic / Q000379:methods; D000077561:Daclizumab; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology / Q000627:therapeutic use; D007155:Immunologic Factors / Q000276:immunology / Q000627:therapeutic use; D007674:Kidney Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D000069283:Rituximab / Q000276:immunology / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018951:Antigens, CD20; D007074:Immunoglobulin G; D007155:Immunologic Factors; C560928:fresolimumab; D000069283:Rituximab; C511911:belimumab; C481642:eculizumab; D000077561:Daclizumab; C502936:tocilizumab
keywords: glomerulonephritis; monoclonal; proteinuria; renal disease