Universität zu Köln

Nuesken, Eva and Weber, Lutz T. (2022). IgA vasculitis nephritis. CURR. OPIN. PEDIATR., 34 (2). S. 209 - 217. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1531-698X

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Abstract

Purpose of review The purpose of this update is to summarize current knowledge on the pathophysiology of immunglobulin A (IgA) vasculitis nephritis (IgAVN) as well as to critically review evidence for established therapeutic regimes and available biomarkers. An additional purpose is to raise the discussion what could be done to further improve our understanding of IgAVN, identify patients at risk for adverse outcome and increase the evidence for therapy recommendations. Recent findings Clinical and experimental studies have established the concept of a multilevel pathogenesis. Toll-like-receptor activation, B cell proliferation, micro-RNAs and complement activation have been identified or confirmed as potential therapeutic targets which can modify the course of the disease. Currently, kidney injury molecule-1, monocyte chemotactic protein-1, N-acetyl-beta-glucosaminidase, and angiotensinogen are the most promising urinary biomarkers for early diagnosis of renal involvement in IgA vasculitis. Close surveillance of all IgAV patients for renal involvement is recommended. Given the multilevel pathogenesis, early treatment of even mild cases should be initiated. Further therapeutic options should be considered in case first-line therapy (mostly corticosteroids) has no effect. The evidence supporting current therapeutic regimes is predominantly based on expert opinion. Prospective studies are needed and should involve substances inhibiting B cell proliferation and complement activation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nuesken, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Lutz T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-657458
DOI:	10.1097/MOP.0000000000001120
Journal or Publication Title:	CURR. OPIN. PEDIATR.
Volume:	34
Number:	2
Page Range:	S. 209 - 217
Date:	2022
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1531-698X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HENOCH-SCHONLEIN PURPURA; IMMUNOGLOBULIN-A; NEPHROPATHY; CHILDREN; CELLS; TONSILLECTOMY; RECEPTORS; OUTCOMES Multiple languages Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65745