Imperial College London
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ProfessorFrederickTam

Faculty of Medicine, Department of Immunology and Inflammation

Ken and Mary Minton Chair of Renal Medicine
 
 
 
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Contact

 

+44 (0)20 3313 2354f.tam

 
 
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Location

 

9N, 15C, Commonwealth BuildingHammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Penfold:2018:10.2147/IJNRD.S129227,
author = {Penfold, R and Prendecki, M and McAdoo, S and Tam, FWK},
doi = {10.2147/IJNRD.S129227},
journal = {International Journal of Nephrology and Renovascular Disease},
pages = {137--148},
title = {Primary IgA nephropathy: current challenges and future prospects},
url = {http://dx.doi.org/10.2147/IJNRD.S129227},
volume = {11},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide, exhibiting a variable clinical and pathological course and significantly contributing to the global burden of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Current standards of care focus on optimization of anti-hypertensive and anti-proteinuric therapies (typically renin-angiotensin system blockade) to reduce disease progression. Much recent attention has focused on whether additional immunosuppression confers better outcomes than supportive management alone and indeed several trials have demonstrated renoprotective effects following use of oral corticosteroids. However, results have been inconsistent and perceived benefits must be balanced against risks and adverse effects associated with generalized immunosuppression, as highlighted by the high-profile STOP-IgAN and TESTING clinical trials. Recent translational research in vitro and animal models of IgAN have generated greater insight into potential therapeutic targets for this complex autoimmune disease. Deeper understanding of the roles of the mucosal immune barrier, complement activation and deposition, T-cell dependent and independent mechanisms of B cell activation, and of the deposition and downstream inflammatory signalling pathways of nephritogenic polymeric IgA1 complexes (eg. signaling of immune receptors via Syk) have formed the rationale for the development of novel agents and clinical trials of more targeted therapies. However, translating findings into clinical practice is challenging, with many immunopathological features of IgAN specific to humans. Recent comprehensive reviews outline current understanding of mechanisms of IgAN as well as ongoing and future clinical trials; it is not our aim to replicate this here. Instead, we take a mechanistic approach to current treatment strategies, outlining advantages and limitations of each before exploring ongoing research with potential translation i
AU  - Penfold,R
AU  - Prendecki,M
AU  - McAdoo,S
AU  - Tam,FWK
DO  - 10.2147/IJNRD.S129227
EP  - 148
PY  - 2018///
SN  - 1178-7058
SP  - 137
TI  - Primary IgA nephropathy: current challenges and future prospects
T2  - International Journal of Nephrology and Renovascular Disease
UR  - http://dx.doi.org/10.2147/IJNRD.S129227
UR  - http://hdl.handle.net/10044/1/57520
VL  - 11
ER  -
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