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IgA Nephropathy: Recent Advances and Prospects
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IgA Nephropathy: Recent Advances and Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (25 January 2024) | Viewed by 8468

Special Issue Editor

Dr. Meritxell Ibernon

E-Mail Website
Guest Editor
Nephrology Department, Hospital Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral, Carrer d’Oriol Martorell, 12, Sant Joan Despí 08970, Barcelona, Spain
Interests: diabetic nephropathy; glomerular diseases; autoimmune renal disease; hypertension; cardiovascular diseases in chronic renal disease

Special Issue Information

Dear Colleagues,

In recent years, a progressive advance in the understanding of the pathogenesis of IgA nephropathy has emerged, but it is still not well defined.

Although an increasing number of clinical trials of therapies for IgA nephropathy are being published, there is still no available treatment, and many of the current treatment strategies are common to other forms of chronic glomerular disease. The development of personalized treatment approaches offering the most appropriate therapy for each patient is an important area of research.

The aim of this Special Issue is to provide a comprehensive overview of the advances in the pathogenesis and novel therapies for IgA nephropathy. A better understanding of the pathogenesis of IgA nephropathy will lead to earlier diagnosis as well as better disease-targeted therapy. Therefore, researchers in the field of glomerular diseases are encouraged to submit their findings as original articles or reviews to this Special Issue.

Dr. Meritxell Ibernon
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pathogenesis of IgA nephropathy
  • novel therapies
  • role of complement system
  • risk factors for disease progression
  • proteomic approach
  • serologic biomarkers
  • histological classification

Published Papers (3 papers)

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Research

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9 pages, 713 KiB  
Article
The Presence of ANCA in IgA Crescentic Nephropathy Does Not Lead to Worse Prognosis with Intensive Rescue Treatment
by Irene Agraz, Zaira Castañeda, María Teresa Sanz-Martínez, Alejandra Gabaldón, Sheila Bermejo, Laura Viñas Gimenez, Roxana Bury, Mónica Bolufer, Marina López-Martínez, Natalia Ramos, Oriol Bestard and María José Soler
J. Clin. Med. 2022, 11(23), 7122; https://doi.org/10.3390/jcm11237122 - 30 Nov 2022
Viewed by 1183
Abstract
Background: Immunoglobulin A nephropathy (IgAN) is the most common glomerulonephritis worldwide. The concomitant presence of both crescentic proliferation and anti-neutrophil cytoplasmic autoantibodies (ANCA) in this pathology represents a rare coincidence. However, it is not clear to what extent the presence of ANCA (IgA [...] Read more.
Background: Immunoglobulin A nephropathy (IgAN) is the most common glomerulonephritis worldwide. The concomitant presence of both crescentic proliferation and anti-neutrophil cytoplasmic autoantibodies (ANCA) in this pathology represents a rare coincidence. However, it is not clear to what extent the presence of ANCA (IgA or IgG) in these patients could have any clinical significance. The aim of the current work is to describe the presence of ANCA (IgA or IgG) in patients with IgAN and crescentic proliferation and its possible clinical implications. Methods: We retrospectively recruited all patients in our center with a histological diagnosis of IgAN with crescentic proliferation between January 2013 and December 2020. The main demographic and clinicopathologic data, fundamental histological characteristics, as well as the treatments implemented and main kidney outcomes, were collected and analyzed at a 6 and 12-month follow-up. Results: Between January 2013 and December 2020, a total of 17 adults were diagnosed with concomitant crescentic proliferation through a kidney biopsy of IgAN. Five (29.4%) patients showed ANCA, three (60%) showed IgA-ANCA and two (40%) showed IgG-ANCA. All ANCA-positive patients had some degree of crescentic proliferation. At diagnosis, the mean age of patients was 48 years old (range: 27–75). Nine of them were women (52%) and the most common clinical presentation was hypertension (71%). At the time of biopsy, the mean serum creatinine and proteinuria were 2.2 mg/dL (DS 1.42) and 3.5 g/mgCr (DS 1.22), respectively, with no statistical differences between ANCA-positive and -negative patients. Histological analyses showed that 11 out of the 12 (91%) ANCA-negative IgAN patients displayed less than 25% cellular crescents, whereas 100% of ANCA-positive IgAN patients displayed more than 25% cellular crescents (p = 0.04). Notably, five (30%) patients displayed fibrinoid necrosis, with four of them (80%) being IgAN-ANCA-positive (p = 0.01). Only one ANCA-negative patient needed renal replacement therapy (RRT) upon admission (5%). The mean serum creatinine and proteinuria were 1.94 mg/dL (DS 1.71) and 1.45 g/gCr (DS 1.78), respectively, within 6 months of immunosuppressive therapy. At 12-month follow-up, the mean creatinine was 1.57 mg/dL (DS 1). Four (23.5%) patients needed RRT at the end of the follow-up and four (23.5%) patients died. Conclusions: Probably due to the limited number of IgAN-ANCA-positive and IgAN-ANCA-negative patients, no significant differences were found between the clinical and laboratory characteristics. IgAN-ANCA-negative patients seemed to display less extracapillary proliferation than IgAN-ANCA-positive patients, who tended to show significantly higher fibrinoid necrosis. There were no differences regarding renal prognosis and patient survival after aggressive immunosuppressive therapy within 6 and 12 months when comparing the two samples. Full article
(This article belongs to the Special Issue IgA Nephropathy: Recent Advances and Prospects)
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Review

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18 pages, 1852 KiB  
Review
A PRoliferation-Inducing Ligand (APRIL) in the Pathogenesis of Immunoglobulin A Nephropathy: A Review of the Evidence
by Mohit Mathur, Tak Mao Chan, Kook-Hwan Oh, Laura Kooienga, Min Zhuo, Cibele S. Pinto and Bobby Chacko
J. Clin. Med. 2023, 12(21), 6927; https://doi.org/10.3390/jcm12216927 - 04 Nov 2023
Cited by 1 | Viewed by 2609
Abstract
A PRoliferation-Inducing Ligand (APRIL), the thirteenth member of the tumor necrosis factor superfamily, plays a key role in the regulation of activated B cells, the survival of long-lived plasma cells, and immunoglobulin (Ig) isotype class switching. Several lines of evidence have implicated APRIL [...] Read more.
A PRoliferation-Inducing Ligand (APRIL), the thirteenth member of the tumor necrosis factor superfamily, plays a key role in the regulation of activated B cells, the survival of long-lived plasma cells, and immunoglobulin (Ig) isotype class switching. Several lines of evidence have implicated APRIL in the pathogenesis of IgA nephropathy (IgAN). Globally, IgAN is the most common primary glomerulonephritis, and it can progress to end-stage kidney disease; yet, disease-modifying treatments for this condition have historically been lacking. The preliminary data in ongoing clinical trials indicate that APRIL inhibition can reduce proteinuria and slow the rate of kidney disease progression by acting at an upstream level in IgAN pathogenesis. In this review, we examine what is known about the physiologic roles of APRIL and evaluate the experimental and epidemiological evidence describing how these normal biologic processes are thought to be subverted in IgAN. The weight of the preclinical, clinical, and genetic data supporting a key role for APRIL in IgAN has galvanized pharmacologic research, and several anti-APRIL drug candidates have now entered clinical development for IgAN. Herein, we present an overview of the clinical results to date. Finally, we explore where more research and evidence are needed to transform potential therapies into clinical benefits for patients with IgAN. Full article
(This article belongs to the Special Issue IgA Nephropathy: Recent Advances and Prospects)
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Other

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30 pages, 863 KiB  
Systematic Review
Secondary IgA Nephropathy and IgA-Associated Nephropathy: A Systematic Review of Case Reports
by Maciej Tota, Vanessa Baron, Katie Musial, Bouchra Derrough, Andrzej Konieczny, Magdalena Krajewska, Kultigin Turkmen and Mariusz Kusztal
J. Clin. Med. 2023, 12(7), 2726; https://doi.org/10.3390/jcm12072726 - 06 Apr 2023
Cited by 1 | Viewed by 3941
Abstract
Primary (pIgAN), secondary IgA nephropathy (sIgAN), and IgA-associated nephropathy can be distinguished. While pIgAN has been thoroughly studied, information about the etiology of sIgAN remains scarce. As concerns sIgAN, several studies suggest that different etiologic factors play a role and ultimately lead to [...] Read more.
Primary (pIgAN), secondary IgA nephropathy (sIgAN), and IgA-associated nephropathy can be distinguished. While pIgAN has been thoroughly studied, information about the etiology of sIgAN remains scarce. As concerns sIgAN, several studies suggest that different etiologic factors play a role and ultimately lead to a pathophysiologic process similar to that of pIgAN. In this article, we review a vast number of cases in order to determine the novel putative underlying diseases of sIgAN. Moreover, updates on the common pathophysiology of primary disorders and sIgAN are presented. We identified liver, gastrointestinal, oncological, dermatological, autoimmune, and respiratory diseases, as well as infectious, iatrogenic, and environmental factors, as triggers of sIgAN. As novel biological therapies for listed underlying diseases emerge, we suggest implementing drug-induced sIgAN as a new significant category. Clinicians should acknowledge the possibility of sIgAN progression in patients treated with TNF-α inhibitors, IL-12/IL-23-inhibitors, immune checkpoint inhibitors, CTLA-4, oral anticoagulants, thioureylene derivatives, and anti-vascular endothelial growth factor drugs. Full article
(This article belongs to the Special Issue IgA Nephropathy: Recent Advances and Prospects)
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