Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
J Clin Invest. 2012 May;122(5):1605-8. doi: 10.1172/JCI63248. Epub 2012 Apr 9.
Cast nephropathy is the result of coprecipitation of immunoglobulin free light chains (FLCs) with Tamm-Horsfall glycoprotein (THP). It is a hallmark of multiple myeloma that has significant consequences. Treatment strategies in the past focused on reduction of serum FLC by control of the myeloma. In this issue, Ying et al. report on their successful synthesis of a cyclized competitor peptide that blocks the binding of FLC to THP. In animal studies, this cyclized peptide was capable of reducing cast formation and kidney injury, representing a novel treatment strategy for cast nephropathy that does not depend on the responsiveness of the myeloma to chemotherapy.
casts 肾病是免疫球蛋白游离轻链 (FLC) 与 Tamm-Horsfall 糖蛋白 (THP) 共沉淀的结果。这是多发性骨髓瘤的一个显著特征，具有重要的影响。过去的治疗策略主要集中在通过控制骨髓瘤来减少血清 FLC。在本期杂志中，Ying 等人报告了他们成功合成了一种环状竞争肽，该肽可以阻断 FLC 与 THP 的结合。在动物研究中，这种环状肽能够减少 casts 的形成和肾脏损伤，为 casts 肾病提供了一种新的治疗策略，该策略不依赖于骨髓瘤对化疗的反应性。
