Drug therapy effective in immune-mediated kidney diseaseAugust 6th, 2008 - 4:20 pm ICT by IANS
Washington, Aug 6 (IANS) Rituximab, a drug, substantially heals kidney injury in patients with membranous nephropathy, a common form of kidney disease, according to a study. The results suggest that this condition that leads to kidney failure in 30-40 percent of cases can actually be healed in some cases.
Membranous nephropathy (also known as membranous glomerulopathy) is one of the most common immune-mediated kidney diseases, and is thought to be caused by autoimmune reactions against the kidney.
The disease, which is characterised by the loss of large amounts of protein in the urine, leads to impaired kidney function that may ultimately require dialysis or renal transplantation.
A variety of immunosuppressive drugs have been tested to inhibit the production of the antibodies that attack the kidneys during the progression of membranous nephropathy, but their effects have been inconsistent.
These therapies also can cause significant toxicity and can suppress a patient’s immune system, exposing the patient to an increased risk of infections and illnesses.
A new drug called rituximab selectively depletes B lymphocytes, the cells that produce the damaging autoantibodies of membranous nephropathy. The drug was initially developed as a cancer treatment for patients with B cell lymphoma, but kidney researchers have shown that this drug also reduces the amount of protein lost in the urine due to membranous nephropathy and is safe.
These same researchers, led by Piero Ruggenenti, of the Negri Bergamo Laboratories in Bergamo, Italy, have now provided evidence that rituximab actually reduces the amount of kidney injury in patients with the disease.
In this study, Ruggenenti and his colleagues treated 50 patients with membranous nephropathy with rituximab. The investigators found that 10 of the patients eventually achieved a complete remission of their disease, seven of whom provided consent to participate in further evaluations, including additional kidney biopsies.
In these patients, deposits of autoantibodies eventually disappeared or were almost entirely reabsorbed and the damage originally noted in certain kidney structures significantly healed.
These findings will appear in the November issue of the Clinical Journal of the American Society Nephrology (CJASN).
Tags: antibodies, autoantibodies, autoimmune reactions, b cell lymphoma, b lymphocytes, bergamo italy, cancer treatment, glomerulopathy, immunosuppressive drugs, kidney disease, kidney diseases, kidney failure, kidney function, kidneys, membranous nephropathy, negri, protein in the urine, remission, renal transplantation, rituximab