title: Biologics for the treatment of autoimmune renal diseases.
abstract: Biological therapeutics (biologics) that target autoimmune responses and inflammatory injury pathways have a marked beneficial impact on the management of many chronic diseases, including rheumatoid arthritis, psoriasis, inflammatory bowel disease, and ankylosing spondylitis. Accumulating data suggest that a growing number of renal diseases result from autoimmune injury - including lupus nephritis, IgA nephropathy, anti-neutrophil cytoplasmic antibody-associated glomerulonephritis, autoimmune (formerly idiopathic) membranous nephropathy, anti-glomerular basement membrane glomerulonephritis, and C3 nephropathy - and one can speculate that biologics might also be applicable to these diseases. As many autoimmune renal diseases are relatively uncommon, with long natural histories and diverse outcomes, clinical trials that aim to validate potentially useful biologics are difficult to design and/or perform. Some excellent consortia are undertaking cohort studies and clinical trials, but more multicentre international collaborations are needed to advance the introduction of new biologics to patients with autoimmune renal disorders. This Review discusses the key molecules that direct injurious inflammation and the biologics that are available to modulate them. The opportunities and challenges for the introduction of relevant biologics into treatment protocols for autoimmune renal diseases are also discussed.
authors.affiliation: Department of Medicine, Centre for Inflammatory Diseases, Monash University, VIC 3800, Australia.|Department of Nephrology, Monash Health, 246 Clayton Road, Clayton, Melbourne, VIC 3168, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Holdsworth
authors.affiliation: Department of Medicine, Centre for Inflammatory Diseases, Monash University, VIC 3800, Australia.
authors.forename: Poh-Yi
authors.initials: PY
authors.lastname: Gan
authors.affiliation: Department of Medicine, Centre for Inflammatory Diseases, Monash University, VIC 3800, Australia.|Department of Nephrology, Monash Health, 246 Clayton Road, Clayton, Melbourne, VIC 3168, Australia.
authors.forename: A Richard
authors.initials: AR
authors.lastname: Kitching
mesh_terms: D019867:Anti-Glomerular Basement Membrane Disease / Q000188:drug therapy / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D001688:Biological Products / Q000627:therapeutic use*; D005922:Glomerulonephritis, IGA / Q000188:drug therapy / Q000276:immunology; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000188:drug therapy* / Q000276:immunology; D008181:Lupus Nephritis / Q000188:drug therapy / Q000276:immunology
chemical_list: D001688:Biological Products; D007155:Immunologic Factors