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Introduction
Nephron Clin Pract 2014;128:203–204
DOI: 10.1159/000369646
Biologic Treatment in Glomerular
Disease
David Jayne
a
Vladimir Tesar
b
a
Vasculitis and Lupus Clinic, Addenbrooke’s Hospital, Cambridge, UK;
b
Department of Nephrology,
1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic
to the standard immunosuppressive treatment demon-
strating its limitations and the current unmet need of, at
least, similarly effective and less toxic treatment. To illus-
trate the close connection between a better understanding
of the pathogenesis of the disease and targeted treatment,
the papers on the pathogenesis of ANCA-associated vas-
culitis [2], lupus nephritis [3], the role of anti-PLA2R an-
tibodies [4] in membranous nephropathy and comple-
ment in membranoproliferative glomerulonephritis [5]
precede the articles dedicated to the treatment of second-
ary [6–8] and primary glomerulonephritides [9–11]. The
final contribution opens new horizons by reviewing the
emerging biologic treatments [12].
We hope you enjoy this introduction to the complex
area of the pathogenesis and targeted treatment of glo-
merular disease and that this information will contribute
to greater awareness, earlier diagnosis and referral, better
treatment and improved outcome for patients with im-
mune-mediated glomerular diseases.
The classification of glomerular disease has been based
almost entirely on renal histology, but an increasing un-
derstanding of the pathogenesis is now introducing
change relevant to the development of newer therapies.
The introduction of corticosteroid and immunosuppres-
sive drugs undoubtedly improved the outcome of patients
with many forms of nephrotic syndrome, lupus nephritis
and ANCA-associated vasculitis, but this non-specific
treatment has been associated with serious short- and
long-term toxicity, especially in patients with frequently
relapsing disease. During the last 10 years, new biologic
(targeted) treatment has expanded our therapeutic arma-
mentarium, especially in refractory, relapsing or intoler-
ant patients with ANCA-associated vasculitis, lupus ne-
phritis and less commonly for other glomerular diseases.
This special topic section of Nephron Clinical Practice
provides the reader with a comprehensive overview of the
widening area of biologic treatments in an increasing
number of glomerular diseases. The first paper [1] returns
Published online: December 13, 2014
Vladimir Tesar
Department of Nephrology, General University Hospital
U nemocnice 2
CZ–128 08 Prague 2 (Czech Republic)
E-Mail vladimir.tesar @ vfn.cz
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