Tomino Yasuhiko
Juntendo University, Tokyo, Japan.
Asian Pacific Renal Research Promotion Office, Medical Corporation SHOWAKAI, Tokyo, Japan.
Nephrology (Carlton). 2018 Oct;23 Suppl 4:76-79. doi: 10.1111/nep.13471.
Chronic kidney disease has become a worldwide problem. Among chronic kidney disease patients, IgA nephropathy is common in the world. Serum levels of galactose deficient (Gd)-IgA1 and Gd-IgA1-specific antibodies are elevated in most IgA nephropathy patients. Glomerular Gd-IgA1 deposition has been observed by immunofluorescence. There are many reports that the anti-proteinuric effect is significantly greater in groups who receive tonsillectomy with steroid pulse therapy in IgA nephropathy patients. Furthermore, patients with tonsillectomy with steroid pulse therapy have shown a strong down-regulation of delta serum IgA/C3 per year and have conserved their renal function. New treatments, that is, Atacicept and glucocorticoid budesonide, have been developed for this disease.
慢性肾脏病已成为一个全球性问题。在慢性肾脏病患者中,IgA肾病在全球都很常见。大多数IgA肾病患者血清中缺乏半乳糖(Gd)-IgA1和Gd-IgA1特异性抗体水平升高。通过免疫荧光观察到肾小球有Gd-IgA1沉积。有许多报告表明,IgA肾病患者接受扁桃体切除联合类固醇脉冲疗法的组抗蛋白尿作用明显更强。此外,接受扁桃体切除联合类固醇脉冲疗法的患者每年血清IgA/C3比值有明显下降,且肾功能得到了保留。针对这种疾病已经研发出了新的治疗方法,即阿他西普和糖皮质激素布地奈德。