{"title":"Lymphocytes and innate immune cells in acute kidney injury and repair","authors":"Kyungho Lee, Hye Ryoun Jang, Hamid Rabb","doi":"10.1038/s41581-024-00875-5","DOIUrl":"10.1038/s41581-024-00875-5","url":null,"abstract":"Acute kidney injury (AKI) is a common and serious disease entity that affects native kidneys and allografts but for which no specific treatments exist. Complex intrarenal inflammatory processes driven by lymphocytes and innate immune cells have key roles in the development and progression of AKI. Many studies have focused on prevention of early injury in AKI. However, most patients with AKI present after injury is already established. Increasing research is therefore focusing on mechanisms of renal repair following AKI and prevention of progression from AKI to chronic kidney disease. CD4+ and CD8+ T cells, B cells and neutrophils are probably involved in the development and progression of AKI, whereas regulatory T cells, double-negative T cells and type 2 innate lymphoid cells have protective roles. Several immune cells, such as macrophages and natural killer T cells, can have both deleterious and protective effects, depending on their subtype and/or the stage of AKI. The immune system not only participates in injury and repair processes during AKI but also has a role in mediating AKI-induced distant organ dysfunction. Targeted manipulation of immune cells is a promising therapeutic strategy to improve AKI outcomes. Here, the authors describe the roles of lymphocytes and innate immune cells in inflammatory responses and repair processes during acute kidney injury (AKI). They also discuss the roles of immune cells in crosstalk pathways that result in AKI-induced distant organ dysfunction.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 12","pages":"789-805"},"PeriodicalIF":28.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Making advance care planning easier for adults with kidney disease and their clinicians","authors":"Ryan D. McMahan, Rebecca L. Sudore","doi":"10.1038/s41581-024-00871-9","DOIUrl":"10.1038/s41581-024-00871-9","url":null,"abstract":"Advance care planning (ACP) has evolved from a narrow focus on end-of-life preference, such as resuscitation, to a continuum of care planning across the life course. Older adults with kidney disease have high morbidity and mortality, and easy-to-use tools can make ACP easier for patients and clinicians.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 9","pages":"564-565"},"PeriodicalIF":28.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monica Suet Ying Ng, Gursimran Kaur, Ross S. Francis, Carmel M. Hawley, David W. Johnson
{"title":"Drug repurposing for glomerular diseases: an underutilized resource","authors":"Monica Suet Ying Ng, Gursimran Kaur, Ross S. Francis, Carmel M. Hawley, David W. Johnson","doi":"10.1038/s41581-024-00864-8","DOIUrl":"10.1038/s41581-024-00864-8","url":null,"abstract":"Drug repurposing in glomerular disease can deliver opportunities for steroid-free regimens, enable personalized multi-target options for resistant or relapsing disease and enhance treatment options for understudied populations (for example, children) and in resource-limited settings. Identification of drug-repurposing candidates can be data driven, which utilizes existing data on disease pathobiology, drug features and clinical outcomes, or experimental, which involves high-throughput drug screens. Information from databases of approved drugs, clinical trials and PubMed registries suggests that at least 96 drugs on the market cover 49 targets with immunosuppressive potential that could be candidates for drug repurposing in glomerular disease. Furthermore, evidence to support drug repurposing is available for 191 immune drug target–glomerular disease pairs. Non-immunological drug repurposing includes strategies to reduce haemodynamic overload, podocyte injury and kidney fibrosis. Recommended strategies to expand drug-repurposing capacity in glomerular disease include enriching drug databases with glomeruli-specific information, enhancing the accessibility of primary clinical trial data, biomarker discovery to improve participant selection into clinical trials and improve surrogate outcomes and initiatives to reduce patent, regulatory and organizational hurdles. Drug repurposing could expand the therapeutic options available to patients with glomerular disease. Here, the authors examine different approaches to the identification of drug candidates, consider current immunosuppressive and non-immunological options and discuss strategies to maximize drug repurposing in glomerular disease.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 11","pages":"707-721"},"PeriodicalIF":28.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anti-nephrin autoantibodies: a paradigm shift in podocytopathies","authors":"Zhao Cui, Ming-hui Zhao","doi":"10.1038/s41581-024-00873-7","DOIUrl":"10.1038/s41581-024-00873-7","url":null,"abstract":"A new study demonstrates that anti-nephrin autoantibodies are not merely markers but also actively contribute to the pathogenesis of minimal change disease and primary focal segmental glomerulosclerosis. This insight not only provides a non-invasive diagnostic alternative to kidney biopsies, but also suggests potential for novel targeted therapies.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 10","pages":"639-640"},"PeriodicalIF":28.6,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The GLP-1 receptor agonist revolution comes to nephrology","authors":"Merlin C. Thomas, Mark E. Cooper","doi":"10.1038/s41581-024-00876-4","DOIUrl":"10.1038/s41581-024-00876-4","url":null,"abstract":"Glucagon-like peptide 1 receptor agonists improve glucose control, promote weight loss and reduce the risk of major cardiovascular events in people with type 2 diabetes mellitus. The FLOW study now provides unequivocal evidence of kidney protective effects with semaglutide in adults with type 2 diabetes mellitus and chronic kidney disease.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 10","pages":"637-638"},"PeriodicalIF":28.6,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CD38 — a new target in renal immune disease","authors":"Ton J. Rabelink, Aiko P. J. de Vries","doi":"10.1038/s41581-024-00874-6","DOIUrl":"10.1038/s41581-024-00874-6","url":null,"abstract":"Targeting of CD38 has been posited as a potential therapeutic avenue for the treatment of immune-mediated conditions. A phase 2 study now reports promising safety, tolerability and intermediate endpoint of efficacy outcomes with the anti-CD38 monoclonal antibody felzartamab in kidney transplant recipients with antibody-mediated rejection.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 10","pages":"641-642"},"PeriodicalIF":28.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}