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1. Immunosuppressive regimens based on Cyclophospamide or Calcineurin inhibitors: Comparison of their effect in the long term outcome of Primary Membranous Nephropathy.

Author

Maria Stangou, Smaragdi Marinaki, Evangelos Papachristou, Kyriaki Kolovou, Erasmia Sambani, Synodi Zerbala, Panagiota Papadea, Olga Balafa, Karolos-Pavlos Rapsomanikis, Aimilios Andrikos, Panagiota Manolakaki, Dorothea Papadopoulou, Efstathios Mitsopoulos, Helen Liakou, Paraskevi-Evi Andronikidi, Vasiliki Choulitoudi, George Moustakas, Dimitra Galitsiou, Eugene Dafnis, Kostas Stylianou, Ioannis Stefanidis, Spyridon Golfinopoulos, Stylianos Panagoutsos, Maria Tsilivigkou, Apostolos Papadogianakis, Ioannis Tzanakis, Athanasios Sioulis, Dimitrios Vlachakos, Eirini Grapsa, Sophia Spaia, Nikolaos Kaperonis, Christos Paliouras, Christos Dioudis, Fani Papoulidou, Theofanis Apostolou, Christos Iatrou, Ioannis Boletis, Dimitrios Goumenos, and Aikaperini Papagianni

Subjects
Medicine, Science
Abstract

IntroductionManagement of the Primary Membranous Nephropathy (PMN) usually involves administration of immunosuppressives. Cyclophosphamide (Cyclo) and Calcineurin Inhibitors (CNIs) are both widely used but only limited data exist to compare their efficacy in long term follow-up.AimThe aim of the present study was to estimate and compare long term effects of Cyclo and CNIs in patients with PMN.Patients-methodsClinical data, histologic findings and long term outcome were retrospectively studied. The response to treatment and rate of relapse was compared between patients treated with CNIs or Cyclo based immunosuppressive regimens.ResultsTwenty three centers participated in the study, with 752 PMN patients (Mean age 53.4(14-87) yrs, M/F 467/285), followed for 10.1±5.7 years. All patients were initially treated with Renin Angiotensin Aldosterone System inhibitors (RAASi) for at least 6 months. Based on their response and tolerance to initial treatment, patients were divided into 3 groups, group I with spontaneous remission, who had no further treatment, group II, continued on RAASi only, and group III on RAASi+immunosuppression. Immunosuppressive regimes were mainly based on CNIs or Cyclo. Frequent relapses and failure to treatment were more common between patients who had started on CNIs (n = 381) compared to those initially treated with Cyclo (n = 110), relapse rate: 25.2% vs. 6.4%, pConclusionsLong term follow up showed that administration of Cyclo in PMN is followed by better preservation of renal function, increased response rate and less frequent relapses, compared to CNIs.

Published
2019
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2. Immunosuppressive regimens based on Cyclophospamide or Calcineurin inhibitors: Comparison of their effect in the long term outcome of Primary Membranous Nephropathy

Author

Christos Dioudis, Eirini Grapsa, Smaragdi Marinaki, Dimitrios S. Goumenos, Aimilios Andrikos, Karolos-Pavlos Rapsomanikis, Christos Iatrou, Synodi Zerbala, Athanasios Sioulis, Evangelos Papachristou, Maria Stangou, Ioannis Stefanidis, Ioannis Boletis, Maria Tsilivigkou, Olga Balafa, Nikolaos Kaperonis, Vasiliki Choulitoudi, Ioannis Tzanakis, Sophia Spaia, Apostolos Papadogianakis, Eugene Dafnis, Erasmia Sambani, Fani Papoulidou, Aikaperini Papagianni, Theofanis Apostolou, Dimitrios Vlachakos, Efstathios Mitsopoulos, Panagiota Manolakaki, Paraskevi-Evi Andronikidi, Christos Paliouras, Kyriaki Kolovou, Dorothea Papadopoulou, Stylianos Panagoutsos, Dimitra Galitsiou, Panagiota Papadea, Helen Liakou, Spyridon Golfinopoulos, Kostas Stylianou, and George Moustakas

Subjects
Male, medicine.medical_treatment, 030232 urology & nephrology, Spontaneous remission, 030204 cardiovascular system & hematology, Pathology and Laboratory Medicine, Glomerulonephritis, Membranous, Gastroenterology, 0302 clinical medicine, Chronic Kidney Disease, Medicine and Health Sciences, Aged, 80 and over, Multidisciplinary, Proteinuria, Drugs, Immunosuppression, Middle Aged, Immunosuppressives, 3. Good health, Treatment Outcome, Nephrology, Medicine, Female, Anatomy, medicine.symptom, Immunosuppressive Agents, Research Article, medicine.drug, Adult, medicine.medical_specialty, Histology, Adolescent, Cyclophosphamide, Science, Immunology, Calcineurin Inhibitors, Renal function, Immune Suppression, Young Adult, 03 medical and health sciences, Signs and Symptoms, Membranous nephropathy, Diagnostic Medicine, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Pharmacology, business.industry, Biology and Life Sciences, Retrospective cohort study, Renal System, medicine.disease, Fibrosis, Calcineurin, Atrophy, business, Developmental Biology
Abstract

IntroductionManagement of the Primary Membranous Nephropathy (PMN) usually involves administration of immunosuppressives. Cyclophosphamide (Cyclo) and Calcineurin Inhibitors (CNIs) are both widely used but only limited data exist to compare their efficacy in long term follow-up.AimThe aim of the present study was to estimate and compare long term effects of Cyclo and CNIs in patients with PMN.Patients-methodsClinical data, histologic findings and long term outcome were retrospectively studied. The response to treatment and rate of relapse was compared between patients treated with CNIs or Cyclo based immunosuppressive regimens.ResultsTwenty three centers participated in the study, with 752 PMN patients (Mean age 53.4(14-87) yrs, M/F 467/285), followed for 10.1±5.7 years. All patients were initially treated with Renin Angiotensin Aldosterone System inhibitors (RAASi) for at least 6 months. Based on their response and tolerance to initial treatment, patients were divided into 3 groups, group I with spontaneous remission, who had no further treatment, group II, continued on RAASi only, and group III on RAASi+immunosuppression. Immunosuppressive regimes were mainly based on CNIs or Cyclo. Frequent relapses and failure to treatment were more common between patients who had started on CNIs (n = 381) compared to those initially treated with Cyclo (n = 110), relapse rate: 25.2% vs. 6.4%, pConclusionsLong term follow up showed that administration of Cyclo in PMN is followed by better preservation of renal function, increased response rate and less frequent relapses, compared to CNIs.

Published
2019

3. Steroids and azathioprine in the treatment of IgA nephropathy

Author

Maria Stangou, Efstathios Alexopoulos, Domniki Ekonomidou, Panagiotis Giamalis, Aikaterini Papagianni, Afroditi Pantzaki, Helen Liakou, Apostolis Tsiantoulas, Dimitrios Memmos, and George Efstratiadis

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, Physiology, Urology, Renal function, Azathioprine, Urine, Methylprednisolone, Nephropathy, Renin-Angiotensin System, Physiology (medical), Internal medicine, Humans, Medicine, Proteinuria, business.industry, Glomerulonephritis, IGA, Glomerulonephritis, Middle Aged, medicine.disease, Endocrinology, Fatty Acids, Unsaturated, Female, medicine.symptom, business, Glomerular Filtration Rate, medicine.drug
Abstract

IgA nephropathy (IgAN) is a very common glomerulonephritis among young adults, but the best therapeutic approach has not been fully elucidated. This study evaluated the effect of two different treatment regimes in IgAN, steroids alone or in combination with azathioprine. Among 122 patients with primary IgA nephropathy diagnosed in the 2000–2007 period, 22 fulfilled the inclusion criteria for the study: estimated glomerular filtration rate (eGRF) ≥30 ml/min/1.73 m2, urine protein (Upr) ≥1 g/24 h, blood pressure (BP)

Published
2011

4. Detection of multiple cytokines in the urine of patients with focal necrotising glomerulonephritis may predict short and long term outcome of renal function

Author

Aikaterini Papagianni, Lazaros Gionanlis, Dimitrios Memmos, Helen Liakou, Christos Bantis, Afroditi Pantzaki, Kostas Pliakos, Maria Stangou, Panagiotis Giamalis, and Georgios Efstratiadis

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Time Factors, Urinary system, Biopsy, Immunology, Renal function, Kidney, Kidney Function Tests, Biochemistry, Gastroenterology, chemistry.chemical_compound, Glomerulonephritis, Epidermal growth factor, Internal medicine, Immunology and Allergy, Medicine, Humans, Molecular Biology, Macrophage inflammatory protein, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Hematology, Middle Aged, Immunohistochemistry, Vascular endothelial growth factor, Treatment Outcome, chemistry, Case-Control Studies, Cytokines, Female, Renal biopsy, business, Transforming growth factor
Abstract

Detection of urinary cytokines in pauci-immune focal segmental necrotizing glomerulonephritis (FSNGN) may provide valuable information about disease pathogenesis and prognosis.Epidermal growth factor (EGF), transforming growth factor (TGF-β1) and vascular endothelial growth factor (VEGF) were measured by ELISA, and Interleukins, monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein (MIP1β) by a multiplex cytokine assay, in 38 patients with FSNGN. Their levels were correlated with severity of histological findings and renal function outcome in short and long term.The percentage of crescents in renal biopsy had positive correlation with TGF-β1 (p=0.004) and IL-15 urinary excretion (p=0.01), and negative correlation with EGF (p=0.01). Increased urinary excretion of IL-6, IL-15, VEGF and MIP-1β was associated with poor renal function outcome, but increased levels of EGF, IL-2 and IL-9 predicted a favourable prognosis. In multiple regression analysis IL-6 and VEGF urinary levels were independent predictors of no-response at the acute phase (p=0.001 and p0.0001, respectively), while, IL-6 was the only factor (p=0.03) predicted worse outcome at the end of follow-up (39.4±45 months).Increased urinary excretion of IL-6, IL-15, VEGF, TGF-β1, MCP-1 and MIP-1β and reduced EGF, IL-2, IL-9 may be associated with histological damage and influence response to treatment in pauci-immune FSNGN.

Published
2011

5. P174 Urinary excretion of Th1, Th2 and Th17 cytokines in idiopathic focal segmental glomerulosclerosis: Preliminary results from a single center

Author

Maria Stangou, Helen Liakou, Aikaterini Papagianni, S. Kasimatis, Georgios Efstratiadis, Dimitrios Memmos, and M. Spartalis

Subjects
medicine.medical_specialty, Pathology, Proteinuria, medicine.diagnostic_test, business.industry, Immunology, Renal function, Histology, Mesangial hypercellularity, Hematology, Urine, Single Center, Biochemistry, Gastroenterology, End stage renal disease, Internal medicine, medicine, Immunology and Allergy, Renal biopsy, medicine.symptom, business, Molecular Biology
Abstract

Introduction Idiopathic Focal Segmental Glomerusclerosis (FSGS) usually leads to end stage renal disease. Cytokines excreted in the urine may represent immunological mechanisms and predict response to treatment. Methods First morning urine samples, collected at day of renal biopsy from 20 FSGS patients [M/F 15/5 age 43.4 yrs (16-75)], and 10 healthy controls, were used to detect IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, INF-gama, G-CSF, GM-CSF, MCP-1, MIP1b, TNF-beta by a multiplex cytokine assay. Histological findings evaluated were percentage of global sclerosis, mesangial hypercellularity, interstitial infiltration and tubular atrophy. Renal function and degree of proteinuria were estimated at the day of renal biopsy and at the end of follow up. Results FSGS patients, comparing to controls had increased urinary levels of IL-1β (0.02 ± 0.04 vs. 0.008 ± 0.004 fg/dl, p = 0.05), IL-5 (0.02 ± 0.02 vs. 0.01 ± 0.004 fg/dl, p = 0.05) IL-12 (0.08 ± 0.07 vs. 0.04 ± 0.01 fg/dl, p = 0.05) GM-CSF (4.9 ± 9 vs. 0.3 ± 0.7 fg/dl, p = 0.03), and MCP-1 (1.2 ± 0.9 vs. 0.2 ± 0.2 fg/dl, p Cytokines which showed significant correlations with histology were mainly produced by Th2 cells. Global sclerosis correlated with: IL-10 (r = 0.6, p = 0.009), IL-13 (r = 0.5, p = 0.03), IL-7 (r = 0.5, p = 0.03) and TNF-beta (r = 0.5, p = 0.03). Degree of mesangial hypercelullarity had negative correlation with IL-4 (r = −0.6, p = 0.01), IL-5 (r = −0.6, p = 0.03), IL-10 (r = −0.7, p = 0.002) and GM-CSF (r = −0.5, 0.04). Patients who did not respond to treatment and progressed to ESRD had increased IL-6 (0.13 ± 0.06 vs.0.07 ± 0.04 fg/dl, p = 0.05), MCP-1 (1.7 ± 0.9 vs. 0.9 ± 0.8 fg/dl, p = 0.02) and reduced IL-17 0.03 ± 0.03 vs.0.05 ± 0.1 fg/dl). Conclusion Th2 cytokines seem to participate to the progression of histological lesions in FSGS and their urinary levels may predict disease outcome.

Published
2012

6. Clinical Nephrology: primary and secondary glomerulonephritis

Author

Maria Stangou, Aki Kuroki, Magdalena Silska, Meg Jardine, Rosanna Coppo, Helen Liakou, Alessandra Grosso, Marco Di Girolamo, Masanori Ito, Domingo Hernández, H. Marco, Y. Arce, Kenji Ito, Paolo Lorusso, Cátia Pêgo, Marco Quaglia, Jacek Zachwieja, Heejung Choi, Salvatore Di Paolo, Domniki Ekonomidou, John Feehally, Ladislava Grcevska, Lidia Kozlovskaya, Hirotsugu Iwatani, Libor Vítek, Andrzej Blumczynski, Guido Ricchiuti, Jana Švarcová, Hala Kfoury, Marian Klinger, Rachele Gallo, Manoj R. Gumber, Eleni Rizopoulou, Timothy S. Johnson, Edgar Lorga, B. Laurent, Elisa Colombini, J.M. Llobet, Momir Polenakovic, Marta Kalousová, Elena Shakhnova, Caili Wang, Peter Heering, Rafid Tofik, Kentaro Ohtoshi, Elena Potencz, Nan Chen, Yaowen Xu, Grazia Vocino, N.L. Kozlovskaya, Alina Casian, Patricia Rullier, Sukran Gurses, Afroditi Pantzaki, Adamasco Cupisti, Bernardo Faria, Vladimir Nikolov, Alice C. Smith, Jakub Zavada, Eva Jancova, Anna Musielak, KyungHwan Jeong, Jessica N. Ivany, Adeline Lacraz, Eduardo B. Coelho, Junying Fan, Silvia Velciov, Tatsuya Shoji, Ju-Young Moon, Kazuo Kitamura, Masahiro Yamamoto, A. Jin Cho, Licia Peruzzi, Martina Giorgetti, Maria Svelto, Valentina Daprà, Natalia Meteleva, Katarzyna Lipkowska, Hong Ren, Jung Eun Lee, Christos Bantis, Panagiotis Patinakis, Himanshu V Patel, Noura AlOudah, Corina Vernic, Richard J. Johnson, Hiroyuki Komatsu, Gheorghe Gluhovschi, Young Tai Shin, Carla Lima, Anhar Ullah, Miltiadis Gerolymos, Gianna Mazzucco, Ilaria Cipollini, Stefan H. Jacobson, Katarzyna Koscielska-Kasprzak, Elena Kamyshova, Pavel Avdonin, Atsushi Yamauchi, Yuji Sato, Yasuhiro Date, Wladimir Szpirt, Eva Honsova, Niya Jia, Henrik Braunitzer, Hye Ryoun Jang, Polina Semenovylh, Yasuhiro Abe, Pankaj R Shah, Qianying Zhang, Larisa Bobrova, Josep M. Grinyó, Sérgio Lemos, Yoshimitsu Yamasaki, Hakan Yavas, Oktawia Mazanowska, Yoshitaka Rakugi, Tadao Akizawa, David Launay, Sang-Ho Lee, Grazia Tamma, R. Poveda, Kang Wook Lee, F.N. Vigotti, Pantelitsa Kalliakmani, Gyl Eanes Barros Silva, Ha Young Oh, Ji Yoon Jung, Florica Gadalean, Saori Nishio, Hargovind L Trivedi, Marten Trendelenburg, Nadia Sami, Yukihiro Wada, Christina Schwandt, Michalis Spartalis, Antoine Huart, Aurélie Hummel, Elisa Loiacono, Linghong Huang, Kostas Pliakos, Marios Papasotiriou, Nicoletta-Maria Kouri, Zdenka Hruskova, Jesus Garrido, Domniki Oikonomidou, M. Picazo, Jacek Manitius, Joachim Lundahl, George Efstratiadis, Alfons Segarra, Giovanni Sorbo, Ivan Topchii, Kamal K. Kaswan, Ole Torffvit, G. Daidola, Danuta Ostalska-Nowicka, Dimitrios Memmos, Valentina Panetta, Patrice Cacoub, YangGyoon Kim, Daniel Cioca, Manuela Bianciotto, Massimo Papale, Vladimira Bednarova, Naoto Katakami, Lina Muzi, Osman Z. Sahin, Javeria Peracha, Satoru Ogahara, Katrin Ivens, Shouichi Fujimoto, Ilona Kaszás, Giovanna Pasquariello, Demetris Christou, Jean-Emmanuel Kahn, Magdalena Grajewska, Xiaoxia Pan, Grazyna Odrowaz-Sypniewska, Arata Horii, Hiromi Rakugi, Elena Lazar, Helena Mareckova, Eliska Potlukova, Giuseppe Grandaliano, L. C. Rump, József Arányi, Dinesh Gera, Valeria T. Okino, Xiaonong Chen, Dong Seok Jang, Andrey Nesen, Dilek Gibyeli Genek, M. Diaz, Marcelina Zabinska, Ligia Petrica, Isabelle Marie, Dae Joong Kim, Pingyan Shen, Olivier Hinschberger, Sulra Lee, Virginia Trandafirescu, Ilona Dziemianko, Won Ik Jang, Ying Wang, Hiroshi Ohno, L. Besso, L. Colla, Dae Eun Choi, Natalia Tchebotareva, Gordana Petrusevska, Ryohei Yamamoto, Rifki Ersoy, Aida Afiani, Enyu Imai, Domenica Lasorsa, Paola Mattei, Maurizio Innocenti, Tânia Sousa, Xavier Fulladosa, Weiming Wang, Ágnes Haris, Maho Watanabe, Michael Walsh, Kálmán Polner, Shinji Fukuda, Annamaria D'Apollo, Atilla Uzum, Margherita Conrieri, Martin Lenicek, Valentina Galchinskaya, Yancun Li, Romana Rysava, Young Rok Ham, Joana Vidinha, Dorota Kaminska, Yoshitaka Isaka, Loredana Colla, Orhan Yucel, Irina Bobkova, Elen Almeida Romão, Beata Sulikowska, Jonathan Barratt, Carmen Vozmediano, ChunGyoo Ihm, Joan Torras, Cristiana Rollino, Itziar Navarro, Takao Saito, Funda Alkan Tasli, Kamal Goplani, Hidetoshi Ito, Frank Bridoux, Elisa Caramello, Mustafa Cirit, Alfred Warzywoda, Francesca M. Bosetti, Yoon-Goo Kim, Manuel Praga, Francois Berthoux, Fabrice Bonnet, Maria Teresa Rocchetti, M. Gomà, B. Svobodova, Zoltán Merán, Miguel Moysés Neto, Benjamin Terrier, Wen Zhang, Pinar Yeniay, Takao Koike, Kenichiro Iio, Olga Li, Lisa Mastrofrancesco, Mikhail Shvetsov, Reiko Hayaishi-Okano, Natalia Chebotareva, Francisco Rivera, Wooseong Huh, Giuseppe Paolo Segoloni, Magdalena Krajewska, Laura Morando, Osvaldo Merege Vieira Neto, Vladimir Tesar, Pauline Belenotti, Lise Thibaudin, Juan Manuel Lopez, Satu Sinikka Pesickova, Qiuhua Huang, Sigrid Lundberg, Christophe Mariat, K. Pinar Ozen, Tatiana Rudenko, Gheorghe Bozdog, Yingying Xie, Masao Kikuchi, Giovanna Valenti, Iva Gunnarsson, Abdulkareem Alsuwaida, Jan Penar, Bengt Rippe, Yoshiharu Tsubakihara, Xiao Li, Jolanta Soltysiak, Mohammed Alghonaim, Luc Saint-Martin, G.P. Segoloni, Loreto Gesualdo, Sufia Hussain, Hesham Mohey, Antonio Pasquariello, Sarah Chung, Francesco Quarello, Omran Bakoush, Miho Kimachi, Elena Khafizova, Roberta Camilla, Ida Valentina Suriano, Cristina Gluhovschi, M. Córica, Flaviu Bob, J. Ballarin, Hidenori Inohara, Maria Grazia Chiappini, Karen Molyneux, Eriko Kinugasa, Rosana Gelpi, Dimitrios S. Goumenos, Alessandro Amore, Piero Stratta, Ki Ryang Na, David Jayne, Liliane Ngango, Emmanuelle Plaisier, Anna Bottai, Antai Zheng, Aruna V. Vanikar, Rafał Donderski, Tae-Won Lee, Raffaella Cravero, Márcio Dantas, Yasuyuki Nagasawa, Giuliano Barsotti, Hiroaki Ogata, H. Hakan Yavas, Vaios Sigounas, and Fang Zhong

Subjects
Transplantation, medicine.medical_specialty, Primary (chemistry), Nephrology, business.industry, Internal medicine, medicine, Glomerulonephritis, Clinical nephrology, medicine.disease, business
Published
2011

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