Ruitong Gao1, Wei Wu2, Yubing Wen1, Xuemei Li3. 1. Division of Nephrology, Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China. 2. Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China. 3. Division of Nephrology, Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China. pumch_lixuemei@sina.com.
Abstract
PURPOSE: 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.
PURPOSE: 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 IgANpatients 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.
Entities:
Keywords:
Hydroxychloroquine; IgA nephropathy; Proteinuria; Remission
Authors: Jicheng Lv; Damin Xu; Vlado Perkovic; Xinxin Ma; David W Johnson; Mark Woodward; Adeera Levin; Hong Zhang; Haiyan Wang Journal: J Am Soc Nephrol Date: 2012-04-26 Impact factor: 10.121
Authors: Douglas D McCarthy; Sidney Chiu; Yunfei Gao; Leslie E Summers-deLuca; Jennifer L Gommerman Journal: Cell Immunol Date: 2006-09-20 Impact factor: 4.868
Authors: Daniel C Cattran; Rosanna Coppo; H Terence Cook; John Feehally; Ian S D Roberts; Stéphan Troyanov; Charles E Alpers; Alessandro Amore; Jonathan Barratt; Francois Berthoux; Stephen Bonsib; Jan A Bruijn; Vivette D'Agati; Giuseppe D'Amico; Steven Emancipator; Francesco Emma; Franco Ferrario; Fernando C Fervenza; Sandrine Florquin; Agnes Fogo; Colin C Geddes; Hermann-Josef Groene; Mark Haas; Andrew M Herzenberg; Prue A Hill; Ronald J Hogg; Stephen I Hsu; J Charles Jennette; Kensuke Joh; Bruce A Julian; Tetsuya Kawamura; Fernand M Lai; Chi Bon Leung; Lei-Shi Li; Philip K T Li; Zhi-Hong Liu; Bruce Mackinnon; Sergio Mezzano; F Paolo Schena; Yasuhiko Tomino; Patrick D Walker; Haiyan Wang; Jan J Weening; Nori Yoshikawa; Hong Zhang Journal: Kidney Int Date: 2009-07-01 Impact factor: 10.612