Document Type
Article
Publication Date
1-1-2017
Identifier
PMCID: PMC5603123 DOI: 10.1155/2017/6232616
Abstract
A plasma component is responsible for altered glomerular permeability in patients with focal segmental glomerulosclerosis. Evidence includes recurrence after renal transplantation, remission after plasmapheresis, proteinuria in infants of affected mothers, transfer of proteinuria to experimental animals, and impaired glomerular permeability after exposure to patient plasma. Therapy may include decreasing synthesis of the injurious agent, removing or blocking its interaction with cells, or blocking signaling or enhancing cell defenses to restore the permeability barrier and prevent progression. Agents that may prevent the synthesis of the permeability factor include cytotoxic agents or aggressive chemotherapy. Extracorporeal therapies include plasmapheresis, immunoadsorption with protein A or anti-immunoglobulin, or lipopheresis. Oral or intravenous galactose also decreases Palb activity. Studies of glomeruli have shown that several strategies prevent the action of FSGS sera. These include blocking receptor-ligand interactions, modulating cell reactions using indomethacin or eicosanoids 20-HETE or 8,9-EET, and enhancing cytoskeleton and protein interactions using calcineurin inhibitors, glucocorticoids, or rituximab. We have identified cardiotrophin-like cytokine factor 1 (CLCF-1) as a candidate for the permeability factor. Therapies specific to CLCF-1 include potential use of cytokine receptor-like factor (CRLF-1) and inhibition of Janus kinase 2. Combined therapy using multiple modalities offers therapy to reverse proteinuria and prevent scarring.
Journal Title
Biomed Res Int
Volume
2017
First Page
6232616
Last Page
6232616
MeSH Keywords
Animals; Calcineurin Inhibitors; Cytokines; Glomerulosclerosis, Focal Segmental; Humans; Janus Kinase 2; Kidney Glomerulus; Permeability; Receptors, Cytokine
Recommended Citation
Savin VJ, Sharma M, Zhou J, et al. Multiple Targets for Novel Therapy of FSGS Associated with Circulating Permeability Factor. Biomed Res Int. 2017;2017:6232616. doi:10.1155/2017/6232616
Included in
Nephrology Commons, Pediatrics Commons, Pharmaceutical Preparations Commons, Therapeutics Commons, Urogenital System Commons
Comments
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher's Link: https://www.hindawi.com/journals/bmri/2017/6232616/