Université de Paris, Centre de Recherche sur l'inflammation, Laboratoire d'Excellence Inflamex, F-75018, Paris, France.
INSERM U1149, Paris, France.
Pediatr Nephrol. 2021 Mar;36(3):497-506. doi: 10.1007/s00467-020-04475-w. Epub 2020 Feb 10.
Childhood IgA nephropathy (cIgAN) differs from the adult by having an abrupt clinical onset, often presenting as an acute attack that can progress to a chronic phase. No treatment guidelines have been established for the treatment of cIgAN. Given the severity of acute attack in children, and the number of life-years at stake, pediatricians prescribe immunosuppression in addition to renin-angiotensin system blockade. Non-specific immunosuppressors, such as corticosteroids, have systemic toxic effects, and given recent therapeutic advances in adult glomerulonephritis, new tailored strategies should be expected for children. The mucosal immune system has been highlighted as a key player in IgAN pathogenesis, and several biomarkers have been identified with a direct role in pathogenesis. In this review, we discuss current studies of conventional and novel therapeutic approaches for cIgAN.
儿童 IgA 肾病（cIgAN）与成人不同，其临床发作突然，常表现为急性发作，可进展为慢性期。目前尚无针对 cIgAN 的治疗指南。鉴于儿童急性发作的严重程度以及生命年限的关系，儿科医生除了使用肾素-血管紧张素系统阻滞剂外，还会开具免疫抑制剂。皮质类固醇等非特异性免疫抑制剂具有全身毒性作用，鉴于成人肾小球肾炎的最近治疗进展，应该为儿童制定新的有针对性的治疗策略。黏膜免疫系统已被确定为 IgA 肾病发病机制中的关键因素，并且已经确定了几个具有直接发病机制作用的生物标志物。在这篇综述中，我们讨论了针对 cIgAN 的传统和新型治疗方法的当前研究。
