title: Hydroxychloroquine alleviates persistent proteinuria in IgA nephropathy.
abstract: OBJECTIVE
  Dendritic cells, Toll-like receptor (TLR), interleukin-6 (IFN-α), interferon-alpha (IFN-α) and tumor necrosis factor-alpha (TNF-α) play an important role in the pathogenesis of IgA nephropathy (IgAN). Hydroxychloroquine (HCQ) is an antimalarial agent and had a notable impact on immune activation by the reduction of circulating activated immune cells that including decreased TLR-expressing cells, reduced IFN-secreting DCs, reduced production of cytokines including IFN-α,IL-6 and TNF-α. We evaluated the efficacy of HCQ in reducing proteinuria in patients with IgAN.
  
  
  METHODS
  Twenty-eight IgAN patients with persistent proteinuria (0.5-2.0 g/24 h) despite treatment with losartan for 3 months were matched to receive HCQ and losartan (group 1) or continue losartan therapy (group 2) for 24 weeks. The primary end point of this prospective, paired case-control study was reduction of proteinuria by 50% or more over entry level.
  
  
  RESULTS
  Six patients (42.9%) in group one versus two patients (14.3%) in group 2 reach the primary end point (P = 0.004). By 24 weeks, the mean urinary protein excretion was 65.9 ± 25.5% (P = 0.002) and 95.3 ± 30.0% (P = 0.791) that of the corresponding baseline value in group 1 and group 2, respectively. Baseline proteinuria and histologic grades, blood pressure control and changes in serum creatinine and eGFR were not different between the two groups.
  
  
  CONCLUSIONS
  In selected patients with IgAN, HCQ is effective in ameliorating proteinuria.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China.
authors.forename: Ruitong
authors.initials: R
authors.lastname: Gao
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China.
authors.forename: Yubing
authors.initials: Y
authors.lastname: Wen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China. pumch_lixuemei@sina.com.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Li
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use*; D001794:Blood Pressure; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D019808:Losartan / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology / Q000652:urine
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000962:Antimalarials; D006886:Hydroxychloroquine; D003404:Creatinine; D019808:Losartan
keywords: Hydroxychloroquine; IgA nephropathy; Proteinuria; Remission