Emerging role of Rituximab in adult minimal change disease: a narrative review of clinical evidence, biomarkers and future perspectives.

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY
Anni Zhong, Yi Yu, Tao Cao, Qijun Wan, Ricong Xu
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引用次数: 0

Abstract

Minimal change disease (MCD) represents a significant cause of nephrotic syndrome in adults, traditionally managed with corticosteroids despite substantial relapse rates. This review critically evaluates the emerging role of rituximab (RTX) in adult MCD management, synthesizing current evidence across multiple clinical scenarios. Recent studies demonstrate RTX's multifaceted efficacy, particularly in new-onset cases and steroid-dependent/frequently relapsing patients, with the discovery of anti-nephrin antibodies providing unprecedented insights into MCD pathogenesis. RTX's therapeutic mechanisms involve anti-nephrin antibody depletion, T-cell subset modulation, and direct podocyte protection, showing encouraging complete remission rates and substantially reduced relapse rates. While RTX offers a more favorable safety profile compared to long-term corticosteroid therapy, current evidence remains predominantly based on retrospective studies with limited sample sizes. Critical research priorities include large-scale prospective trials, standardization of treatment protocols, and further investigation of anti-nephrin antibodies as therapeutic targets. This review provides evidence-based insights for clinical decision-making while highlighting crucial areas for future investigation in RTX-based MCD management.

利妥昔单抗在成人微小变化疾病中的新作用:临床证据、生物标志物和未来前景的叙述性回顾。
微小变化病(MCD)是成人肾病综合征的一个重要原因,传统上使用皮质类固醇治疗,尽管复发率很高。这篇综述批判性地评估了利妥昔单抗(RTX)在成人MCD治疗中的新作用,综合了目前在多种临床情况下的证据。最近的研究表明,RTX具有多方面的疗效,特别是在新发病例和类固醇依赖/频繁复发的患者中,抗nephrin抗体的发现为MCD的发病机制提供了前所未有的见解。RTX的治疗机制包括抗nephrin抗体耗竭、t细胞亚群调节和直接足细胞保护,显示出令人鼓舞的完全缓解率和显著降低复发率。虽然与长期皮质类固醇治疗相比,RTX提供了更有利的安全性,但目前的证据仍然主要基于有限样本量的回顾性研究。关键的研究重点包括大规模的前瞻性试验,标准化的治疗方案,以及进一步研究抗肾素抗体作为治疗靶点。本综述为临床决策提供了基于证据的见解,同时强调了基于rtx的MCD管理的未来研究的关键领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Nephrology
BMC Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.30
自引率
0.00%
发文量
375
审稿时长
3-8 weeks
期刊介绍: BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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