Rituximab might be working in a non B cell mediated manner in FSGS recurrence post transplant.
A new study by Fornoni et al showed this in an elegant way.
Some summary points
1. 41 patients were studied, post transplant and 14 were controls and remaining received rituxian as part of their induction.
2. Fewer podocytes with SMPDL-3b protein in biopsies from recurrent FSGS were found.
3. Serum from patients with recurrent FSGS had a decrease in both SMPDL -3b and sphingomyelinase activity.
4 They predicated that rituximab preserves SMPDL-3b expression in podocytes.
5.The above part was prevented with anti CD20 treatment.
6. They studied SMPDL-3b protein, cytoskeleton remodeling in cultured normal human podocytes that had been exposed to patient sera with or without rituximab.
7. Over-expression of SMPDL-3b or treatment with Anti CD20 was able to prevent recurrent FSGS and showed preservation of cytoskeleton.
8.These data suggest that modulation of the sphigolipid related proteins might be playing a role in causing recurrent FSGS and perhaps anti CD20 agents are inhibiting this process in a B cell independent fashion.
Key: SMPDL= sphingomyelin phosphdiesterase acid like.
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- FGF-23 and Mortality Journal Club
- Curbside Consults
- It's official -- chocolate linked to heart health
- Concept Map of MPGN pattern of Injury
- NEJM article highlights Malpractice Risk by Specia...
- IN the NEWS:- Internet and Nephrology
- Pseudo-nephrotic Syndrome
- TOPIC DISCUSSION: Retinal-Renal Diseases
- CLINICAL CASE 41: ANSWERS and SUMMARY
- Topic Discussion: Uromodulin Associated Kidney Dis...
- Nephrology Crosswords-History of Nephrology
- The "Nephrologist"as a patient advocate
- Mohan foundation: First of its Kind in ASIA
- NephroPlus, a new email group to join for discussi...
- TRIBE AKI Consortium
- Consult Rounds: Alkalemia causing Metabolic Acidos...
- IN THE NEWS: Rituximab Targeting Podocytes in Recu...
- IN THE NEWS: SuPAR circulating Factor for FSGS
- Green tea and Tacrolimus
- Consult Rounds: High Uric Acid
- Topic Discussion: Non glucose based solutions for ...
- The Art of Medicine: Let’s Not Lose It In Nephrol...
- CLINICAL CASE 40: ANSWERS AND SUMMARY
- TOPIC DISCUSSION: Adequacy of Dialysis HD vs. PD
- ▼ August (24)
- ► 2010 (461)