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Immunoadsorption in Autoimmune Diseases Affecting the Kidney
- Source :
- Seminars in Nephrology. 37:478-487
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Summary Autoantibodies play an important role in the pathophysiology of renal involvement in systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), systemic vasculitis, and anti–glomerular basement membrane disease (or Goodpasture syndrome). Direct removal of autoantibodies therefore has been tried in various ways, first by plasma exchange. Today, immunoadsorption is the extracorporeal method that most effectively removes (pathogenic) immune complexes and antibodies. Although past data have shown efficacy and biocompatibility of immunoadsorption in (renal) SLE, it is still an experimental and expensive procedure, and evidence from randomized controlled trials is needed. Nevertheless, immunoadsorption is being used as a rescue therapy in life-threatening situations of SLE patients because of its fast mode of action and its acceptable safety profile. In granulomatosis with polyangiitis (GPA) (or Wegener’s granulomatosis), microscopic polyangiitis (MPA), and anti–glomerular basement membrane disease, the current standard is plasma exchange. Immunoadsorption, which probably would reduce the autoantibody burden more effectively, might be an even better more effective option, but sufficient evidence is lacking.
- Subjects :
- 030203 arthritis & rheumatology
Kidney
Anti-Glomerular Basement Membrane Disease
business.industry
Autoantibody
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
030204 cardiovascular system & hematology
medicine.disease
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Immune system
Nephrology
Immunology
medicine
Humans
Lupus Erythematosus, Systemic
Goodpasture syndrome
Immunoadsorption
business
Microscopic polyangiitis
Granulomatosis with polyangiitis
Immunosorbent Techniques
Autoantibodies
Systemic vasculitis
Subjects
Details
- ISSN :
- 02709295
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Seminars in Nephrology
- Accession number :
- edsair.doi.dedup.....8b867cc67226f793f23dad7941d85a34