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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2013
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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. |
format | Online Article Text |
id | pubmed-3567875 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
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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