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Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up

AIMS: To assess the long-term therapeutic benefit of temporary depletion of B lymphocytes in patients with idiopathic membranous glomerulopathy (MGN) and search for potential predictors of response. PATIENTS AND METHODS: The patients included had been diagnosed with biopsy-proven MGN in the absence...

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Autores principales: Lionaki, Sophia, Marinaki, Smaragdi, Nakopoulou, Lydia, Skalioti, Chrysanthi, Iniotaki, Aliki, Sfikakis, Petros P., Siamopoulos, Costas, Boletis, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3567875/
https://www.ncbi.nlm.nih.gov/pubmed/23573072
http://dx.doi.org/10.1159/000345487
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author Lionaki, Sophia
Marinaki, Smaragdi
Nakopoulou, Lydia
Skalioti, Chrysanthi
Iniotaki, Aliki
Sfikakis, Petros P.
Siamopoulos, Costas
Boletis, John
author_facet Lionaki, Sophia
Marinaki, Smaragdi
Nakopoulou, Lydia
Skalioti, Chrysanthi
Iniotaki, Aliki
Sfikakis, Petros P.
Siamopoulos, Costas
Boletis, John
author_sort Lionaki, Sophia
collection PubMed
description AIMS: To assess the long-term therapeutic benefit of temporary depletion of B lymphocytes in patients with idiopathic membranous glomerulopathy (MGN) and search for potential predictors of response. PATIENTS AND METHODS: The patients included had been diagnosed with biopsy-proven MGN in the absence of secondary causes. Estimated glomerular filtration rate should be above 30 ml/min/1.73 m(2) and 24-hour proteinuria 3 g/day or more. Patients who had been treated with cyclosporine or cytotoxic agents the year prior to study entry were excluded. Depletion of B cells was achieved with rituximab, which was administered intravenously for 4 consecutive weeks. Partial remission was defined as a >50% decrease in proteinuria with absolute proteinuria <3 g/day, while complete remission was defined as a >50% decrease in proteinuria and an absolute protein excretion <0.3 g/day. RESULTS: Twelve patients were studied (4 females/8 males) with a mean age of 51.3 years. No major adverse effects were observed. During a median follow-up time of 48 months, 11/12 (91.6%) patients achieved remission [7/12 (58.3%) complete remission and 4/12 (33.3%) partial remission], while 1 patient did not respond to therapy. Twelve months after therapy, 68.8% (p = 0.003) of cases had achieved partial and 28.4% complete remission. Measurements of lymphocyte subpopulations did not reveal any changes except for the B cell depletion. B cell infiltrates captured per mm(3) of renal tissue in the diagnostic biopsy did not correlate with subsequent response. CONCLUSION: Depletion of B cells in idiopathic MGN was well tolerated and resulted in significant and long-lasting response rates in a series of 12 patients.
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spelling pubmed-35678752013-04-09 Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up Lionaki, Sophia Marinaki, Smaragdi Nakopoulou, Lydia Skalioti, Chrysanthi Iniotaki, Aliki Sfikakis, Petros P. Siamopoulos, Costas Boletis, John Nephron Extra Original Paper AIMS: To assess the long-term therapeutic benefit of temporary depletion of B lymphocytes in patients with idiopathic membranous glomerulopathy (MGN) and search for potential predictors of response. PATIENTS AND METHODS: The patients included had been diagnosed with biopsy-proven MGN in the absence of secondary causes. Estimated glomerular filtration rate should be above 30 ml/min/1.73 m(2) and 24-hour proteinuria 3 g/day or more. Patients who had been treated with cyclosporine or cytotoxic agents the year prior to study entry were excluded. Depletion of B cells was achieved with rituximab, which was administered intravenously for 4 consecutive weeks. Partial remission was defined as a >50% decrease in proteinuria with absolute proteinuria <3 g/day, while complete remission was defined as a >50% decrease in proteinuria and an absolute protein excretion <0.3 g/day. RESULTS: Twelve patients were studied (4 females/8 males) with a mean age of 51.3 years. No major adverse effects were observed. During a median follow-up time of 48 months, 11/12 (91.6%) patients achieved remission [7/12 (58.3%) complete remission and 4/12 (33.3%) partial remission], while 1 patient did not respond to therapy. Twelve months after therapy, 68.8% (p = 0.003) of cases had achieved partial and 28.4% complete remission. Measurements of lymphocyte subpopulations did not reveal any changes except for the B cell depletion. B cell infiltrates captured per mm(3) of renal tissue in the diagnostic biopsy did not correlate with subsequent response. CONCLUSION: Depletion of B cells in idiopathic MGN was well tolerated and resulted in significant and long-lasting response rates in a series of 12 patients. S. Karger AG 2013-01-05 /pmc/articles/PMC3567875/ /pubmed/23573072 http://dx.doi.org/10.1159/000345487 Text en Copyright © 2013 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Original Paper
Lionaki, Sophia
Marinaki, Smaragdi
Nakopoulou, Lydia
Skalioti, Chrysanthi
Iniotaki, Aliki
Sfikakis, Petros P.
Siamopoulos, Costas
Boletis, John
Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up
title Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up
title_full Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up
title_fullStr Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up
title_full_unstemmed Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up
title_short Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up
title_sort depletion of b lymphocytes in idiopathic membranous glomerulopathy: results from patients with extended follow-up
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3567875/
https://www.ncbi.nlm.nih.gov/pubmed/23573072
http://dx.doi.org/10.1159/000345487
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