Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Division of Nephrology, Nationwide Children's Hospital, Columbus, OH, USA.
Curr Rheumatol Rep. 2018 Aug 14;20(10):60. doi: 10.1007/s11926-018-0766-9.
Lupus nephritis is a frequent complication of systemic lupus erythematosus and is more common and severe in children. This is a disease of the immune system characterized by T cell, B cell, and complement activation, as well as immune complex formation and deposition. The introduction of steroids and later cyclophosphamide transformed lupus nephritis from a fatal to a treatable condition. However, the standard therapies currently used for treatment carry significant toxicity and chronic kidney disease still remains a far too frequent outcome. To address these issues, we will review current and emerging induction therapies in LN.
Several clinical trials have been undertaken to test more effective and safer drugs, often targeting mechanistic disease pathways. At present, it is difficult to identify an induction regimen that is more effective and less toxic than the standard of care; however, we believe continuing efforts in drug development will bring breakthrough agents to clinics.
狼疮肾炎是系统性红斑狼疮的常见并发症，在儿童中更为常见且更严重。这是一种免疫系统疾病，其特征是 T 细胞、B 细胞和补体的激活，以及免疫复合物的形成和沉积。类固醇和后来的环磷酰胺的引入将狼疮肾炎从致命性疾病转变为可治疗的疾病。然而，目前用于治疗的标准疗法具有显著的毒性，慢性肾脏病仍然是一个过于常见的结局。为了解决这些问题，我们将综述 LN 的现有和新兴诱导疗法。
已经进行了几项临床试验来测试更有效和更安全的药物，这些药物通常针对的是疾病的机制途径。目前，很难确定一种比标准治疗更有效且毒性更小的诱导方案；然而，我们相信药物开发的持续努力将为临床带来突破性的药物。
