Rush University Medical Center, Division of Nephrology, Chicago, Illinois, USA.
Curr Opin Nephrol Hypertens. 2023 Mar 1;32(2):199-203. doi: 10.1097/MNH.0000000000000865. Epub 2022 Dec 23.
The ISN/RPS lupus nephritis classification is in the process of undergoing a revision. It has lost its way and morphed from a classification based on pathophysiology of disease into a staging system based on the extent of spread and prognosis.
There are multiple different pathophysiologic processes that contribute to lupus nephritis. The current classification is inadequate, as it does not highlight these differences and thus squanders the opportunity to develop targeted therapies. Its focus is on the extent of disease as opposed to the pattern of injury, which defines the disease. To delineate the cause, we must include immunofluorescent and electron microscopy, which will help define the pattern of injury.
To determine eventual targeted treatments for lupus nephritis, we must first classify the disease according to the available pathophysiologic mechanisms. In the upcoming revision, including the immunofluorescence and electron microscopy and eliminating the overemphasis on extent of disease are the first steps to categorizing the lupus nephritis classes accurately.
ISN/RPS 狼疮肾炎分类正在进行修订。它已经偏离了最初基于疾病病理生理学的分类，变成了一种基于疾病扩散程度和预后的分期系统。
有多种不同的病理生理过程导致狼疮肾炎。目前的分类并不完善，因为它没有突出这些差异，从而浪费了开发靶向治疗的机会。它的重点是疾病的程度，而不是定义疾病的损伤模式。为了确定病因，我们必须包括免疫荧光和电子显微镜检查，这将有助于确定损伤模式。
为了确定狼疮肾炎的最终靶向治疗方法，我们必须首先根据现有的病理生理机制对疾病进行分类。在即将进行的修订中，包括免疫荧光和电子显微镜检查，并消除对疾病程度的过分强调，是准确分类狼疮肾炎的第一步。
