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ЛЕЧЕНИЕ ГЛОМЕРУЛОПАТИЙ ЦИКЛОСПОРИНОМ: ПРАВИЛЬНЫЙ ПОДХОД С НЕВЕРНЫМ ОБОСНОВАНИЕМ

https://doi.org/10.24884/1561-6274-2010-14-4-9-22

Аннотация

В настоящее время мы являемся свидетелями процесса выхода практической медицины на новый виток своего развития. В мировой медицинской науке создана и набирает силу новая концепция «персонализированной медицины». Основу такой медицины XXI века составляют успехи генетики (фармакогенетики), молекулярной биологии, биохимии, физиологии (экспериментальные исследования). Ярким примером этому может служить почти 30-летняя история изучения вопроса об эффективности применения циклоспорина в лечении нефропатий. Сейчас можно считать доказанным, что циклоспорин действует не только на иммунокомпетентные клетки, но способен восстанавливать сложную структутрно-функциональную организацию подоцитов, существенно повреждающуюся при гломерулопатиях разного генеза. В настоящее время все большее число исследователей склоняются к мысли о том, что при ряде нефропатий (стероидрезистентная болезнь минимальных изменений, мебранозная нефропатия, фокально-сегментарный гломерулосклероз) комбинация циклоспорина с низкими дозами глюкокортикоидов может и должна рассматриваться в качестве терапии первой линии.

Об авторе

А. В. Смирнов
Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Россия

кафедра пропедевтики внутренних болезней,

Научно-исследовательский институт нефрологии.

197022, Санкт-Петербург, ул. Л.Толстого, д. 17, СПбГМУ им. акад. И.П. Павлова, корп. 54, кафедра пропедевтики внутренних болезней. Тел.: (812) 234-01-65; Факс: (812) 234-65-30.



Список литературы

1. Cattran DC, Alexopoulos E, Heering P et al. Cyclosporin in idiopathic glomerular disease associated with the nephrotic syndrome: workshop recommendations. Kidney Int 2007; 72 (12): 1429-1447

2. Козловская ЛВ. Хронический гломерулонефрит: аргументы в пользу применения циклоспорина. Клиническая нефрология 2010; 3: 56-61

3. Захарова ЕВ, Бирюкова ЛС. Роль циклоспорина в лечении идиопатического гломерулонефрита и волчаночного нефрита. Нефрология и диализ 2010; 12(2): 126-141

4. Calne RY, Rolles K, White DJ et al. Cyclosporin A initiallyas the only immunosuppressant in 34 recipients of cadaveric organs: 32 kidneys, 2 pancreases, and 2 livers. Lancet 1979; 2 (8151):1033-1036

5. Gallay PA. Cyclophilin inhibitors. Clin Liver Dis 2009; 13(3): 403-417

6. Liu J, Farmer JD Jr, Lane WS et al. Calcineurin is a common target of cyclophilin-cyclosporin A and FKBP-FK506 complexes. Cell 1991; 66(4): 807-815

7. Thomson AW. The spectrum of action of new immunosuppressive drugs. Clin Exp Immunol 1992; 89(2): 170-173

8. Bram RJ, Hung DT, Martin PK et al. Identification of the immunophilins capable of mediating inhibition of signal transduction by cyclosporin A and FK506: roles of calcineurin binding and cellular location. Mol Cell Biol 1993; 13(8): 4760-4769

9. Fruman DA, Burakoff SJ, Bierer BE. Immunophilins in protein folding and immunosuppression. FASEB J. 1994; 8(6): 391-400

10. Clardy J. The chemistry of signal transduction. Proc Natl Acad Sci USA 1995; 92(1): 56-61

11. Braun W, Kallen J, Mikol V et al. Three-dimensional structure and actions of immunosuppressants and their immunophilins. FASEB J. 1995: 9(1): 63-72

12. Tajima K, Amakawa R, Ito T et al. Immunomodulatory effects of cyclosporin A on human peripheral blood dendritic cell subsets. Immunology 2003; 108(3):321-328

13. Galat A, Bua J. Molecular aspects of cyclophilins mediating therapeutic actions of their ligands. Cell Mol Life Sci 2010; 67(20): 3467-3488

14. Мейл Д. Иммунология /Д. Мейл, Дж. Бростофф, Д. Б. Рот, А. Ройтт/ Пер. с англ. М: Логосфера 2007. – 568 с

15. Shalhoub RJ. Pathogenesis of lipoid nephrosis: a disorder of T-cell function. Lancet 1974; 2(7880): 556-560

16. Meyrier AY. Treatment of focal segmental glomerulosclerosis with immunophilin modulation: when did we stop thinking about pathogenesis? Kidney Int 2009; 76(5): 487-491

17. Savin VJ, Sharma R, Lovell HB, Welling DJ. Measurement of albumin reflection coefficient with isolated rat glomeruli. J Am Soc Nephrol 1992; 3 (6): 1260-1269

18. Savin VJ, Sharma R, Sharma M et al. Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental glomerulosclerosis. N Engl J Med 1996; 334 (14): 878-883

19. Cattran D, Neogi T, Sharma R et al. Serial estimates of serum permeability activity and clinical correlates in patients with native kidney focal segmental glomerulosclerosis. J Am Soc Nephrol 2003; 14 (2): 448-453

20. Carraro M, Caridi G, Bruschi M et al. Serum glomerular permeability activity in patients with podocin mutations (NPHS2) and steroid-resistant nephrotic syndrome. J Am Soc Nephrol 2002; 13 (7): 1946-1952

21. Мухин НА, Тареева ИЕ, Краснова ТН, Шилов ЕМ, Мирошниченко НГ. Лечение нефротической формы хронического гломерулонефрита сандиммуном (циклоспорином А). Тер арх 1995; 67 (8): 13-15

22. Cattran DC, Appel GB, Hebert LA et al. A randomized trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis. North America Nephrotic Syndrome Study Group. Kidney Int 1999; 56 (6): 2220-2226

23. Cattran DC, Appel GB, Hebert LA et al. Cyclosporine in patients with steroid-resistant membranous nephropathy: a randomized trial. Kidney Int 2001; 59 (4):1484-1490

24. Braun N, Schmutzler F, Lange C et al. Immunosuppressive treatment for focal segmental glomerulosclerosis in adults. Cochrane Database Syst Rev 2008; 16 (3): CD003233

25. Austin HA 3 rd , Illei GG, Braun MJ. Balow JE. Randomized, controlled trial of prednisone, cyclophosphamide, and cyclosporine in lupus membranous nephropathy. J Am Soc Nephrol 2009; 20 (4): 901-911

26. Goumenos DS, Katopodis KP, Passadakis P et al. Corticosteroids and ciclosporin A in idiopathic membranous nephropathy: higher remission rates of nephrotic syndrome and less adverse reactions than after traditional treatment with cytotoxic drugs. Am J Nephrol 2007; 27 (3): 226-231

27. Ronkainen J, Autio-Harmainen H, Nuutinen M. Cyclosporin A for the treatment of severe Henoch-Schцnlein glomerulonephritis. Pediatr Nephrol 2003; 18 (11): 1138-1142

28. Alexopoulos E, Papagianni A, Tsamelashvili M et al. Induction and long-term treatment with cyclosporine in membranous nephropathy with the nephrotic syndrome. Nephrol Dial Transplant 2006; 21 (11): 3127-3132

29. Ogawa H, Kameda H, Amano K, Takeuchi T. Efficacy and safety of cyclosporine A in patients with refractory systemic lupus erythematosus in a daily clinical practice. Lupus 2010; 19 (2): 162-169

30. Kiyomasu T, Shibata M, Kurosu H et al. Cyclosporin A treatment for membranoproliferative glomerulonephritis type II. Nephron 2002; 91 (3):509-511

31. Shin JI, Park JM, Shin YH et al. Cyclosporin A therapy for severe Henoch-Schцnlein nephritis with nephrotic syndrome. Pediatr Nephrol 2005; 20 (8):1093-1097

32. Plank C, Kalb V, Hinkes B et al. Cyclosporin A is sperior to cyclophosphamide in children with steroid-resistant nephrotic syndrome-a randomized controlled multicentre trial by the Arbeitsgemeinschaft fьr Pдdiatrische Nephrologie. Pediatr Nephrol 2008; 23 (9): 1483-1493

33. Heidet L, Bongers EM, Sich M et al. In vivo expression of putative LMX1B targets in nail-patella syndrome kidneys. Am J Pathol 2003; 163 (1): 145-155

34. Meyrier A. Antiproteinuric and immunological effects of cyclosporin A in the treatment of glomerular diseases. Nephrol Dial Transplant 1992; 7 Suppl 1: 80-84

35. Schrijver G, Assmann KJ, Wetzels JF, Berden JH. Cyclosporin A reduces albuminuria in experimental anti-GBM nephritis independently from changes in GFR. Nephrol Dial Transplant 1995; 10 (7): 1149-1154

36. Zietse R, Wenting GJ, Kramer P et al. Effects of cyclosporin A on glomerular barrier function in the nephrotic syndrome. Clin Sci (Lond) 1992; 82 (6): 641-650

37. Kanwar YS, Linker A, Farquhar MG. Increased permeability of the glomerular basement membrane to ferritin after removal of glycosaminoglycans (heparan sulfate) by enzyme digestion. J Cell Biol 1980; 86 (2): 688-693

38. Rossi M, Morita H, Sormunen R et al. Heparan sulfate chains of perlecan are indispensable in the lens capsule but not in the kidney. EMBO J 2003; 22 (2): 236-245

39. Harvey SJ, Jarad G, Cunningham J et al. Disruption of glomerular basement membrane charge through podocyte-specific mutation of agrin does not alter glomerular permselectivity. Am J Pathol 2007; 171 (1): 139-152

40. Bensman A, Niaudet P. Non-immunologic mechanisms of calcineurin inhibitors explain its antiproteinuric effects in genetic glomerulopathies. Pediatr Nephrol 2010; 25 (7): 1197-1199

41. Charbit M, Gubler MC, Dechaux M et al. Cyclosporin therapy in patients with Alport syndrome. Pediatr Nephrol 2007; 22 (1): 57-63

42. Massella L, Muda AO, Legato A et al. Cyclosporine A treatment in patients with Alport syndrome: a single-center experience. Pediatr Nephrol 2010; 25 (7): 1269-1275

43. Malina M, Cinek O, Janda J, Seeman T. Partial remission with cyclosporine A in a patient with nephrotic syndrome due to NPHS2 mutation. Pediatr Nephrol 2009; 24 (10): 2051-2053

44. Ruf RG, Lichtenberger A, Karle SM et al. Patients with mutations in NPHS2 (podocin) do not respond to standard steroid treatment of nephrotic syndrome. J Am Soc Nephrol 2004; 15 (3): 722-732

45. Gellermann J, Stefanidis CJ, Mitsioni A, Querfeld U. Successful treatment of steroid-resistant nephrotic syndrome associated with WT1 mutations. Pediatr Nephrol 2010; 25 (7): 1285-1289

46. Faul C, Asanuma K, Yanagida-Asanuma E et al. Actin up: regulation of podocyte structure and function by components of the actin cytoskeleton. Trends Cell Biol 2007; 17 (9): 428-437

47. Mundel P, Reiser J. Proteinuria: an enzymatic disease of the podocyte? Kidney Int 2010; 77 (7): 571-580

48. Kriz W, Hackenthal E, Nobiling R et al. A role for podocytes to counteract capillary wall distension. Kidney Int 1994; 45 (2): 369-376

49. St John PL, Abrahamson DR. Glomerular endothelial cells and podocytes jointly synthesize laminin-1 and -11 chains. Kidney Int 2001; 60 (3): 1037-1046

50. Ina K, Kitamura H, Tatsukawa S et al. Clomerular podocyte endocytosis of the diabetic rat. J Electron Microsc (Tokyo) 2002; 51 (4): 275-279

51. Tryggvason K, Wartiovaara J. Molecular basis of glomerular permselectivity. Curr Opin Nephrol Hypertens 2001; 10 (4): 543-549

52. Kestila M, Lenkkeri U, Mдnnikkц M et al. Positionally cloned gene for a novel glomerular protein-nephrinis mutated in congenital nephrotic syndrome. Mol Cell 1998; 1 (4): 575-582

53. Faul C, Donnelly M, Merscher-Gomez S et al. The actin cytoskeleton of kidney podocytes is a direct target of the antiproteinuric effect of cyclosporine A. Nat Med 2008; 14 (9): 931-938

54. Miao J, Fan Q, Cui Q et al. Newly identified cytoskeletal components are associated with dynamic changes of podocyte foot processes. Nephrol Dial Transplant 2009; 24 (11): 3297-3305

55. Yoshikawa N, Ito H, Akamatsu R et al. Clomerular podocyte vacuolation in focal segmental glomerulosclerosis. Arch Pathol Lab Med 1986; 110 (5): 394-398

56. Farquhar MG, Palade GE. Clomerular permeability. II. Ferritin transfer across the glomerular capillary wall in nephrotic rats. J Exp Med 1961; 114: 699-716

57. Craham RC Jr, Karnovsky MJ. Clomerular permeability. Ultrastructural cytochemical studies using peroxidases as protein tracers. J Exp Med 1966; 124 (6): 1123-1134

58. Van den Berg JG, van den Bergh Weerman MA, Assmann KJ et al. Podocyte foot process effacement is not correlated with the level of proteinuria in human glomerulopathies. Kidney Int 2004; 66 (5): 1901-1906

59. Chuang PY, He JC. Signaling in regulation of podocyte phenotypes. Nephron Physiol 2009; 111 (2): p9-15

60. Ina K, Kitamura H, Tatsukawa S et al. Clomerular podocyte endocytosis of the diabetic rat. J Electron Microsc (Tokyo) 2002; 51 (4): 275-279

61. Hartleben B, Godel M, Meyer-Schwesinger C. et al. Autophagy influences glomerular disease susceptibility and maintains podocyte homeostasis in aging mice. J Clin Invest 2010; 120 (4): 1084-1096

62. Morigi M, Buelli S, Angioletti S et al. In response to protein load podocytes reorganize cytoskeleton and modulate endothelin-1 gene: implication for permselective dysfunction of chronic nephropathies. Am J Pathol 2005; 166 (5): 1309-1320

63. Смирнов АВ, Добронравов ВА, Неворотин АИ и др. Гомоцистеин вызывает повреждения не только клубочкового, но и канальцевого отдела нефрона. Нефрология 2005; 9 (3): 81-87

64. Смирнов АВ, Добронравов ВА, Неворотин АИ и др. Гипергомоцистеинемия усугубляет повреждения нефрона при экспериментальной хронической почечной недостаточности. Нефрология 2005; 9 (4): 67-74

65. Tipping PG. Are podocytes passive or provocative in proteinuric glomerular pathology? J Am Soc Nephrol 2008; 19 (4): 651-653

66. Abe K, Miyazaki M, Koji T et al. Enhanced expression of complement C5a receptor mRNA in human diseased kidney assessed by in situ hybridization. Kidney Int 2001; 60 (1): 137-146

67. Nangaku M, Shankland SJ, Couser WG. Cellular response to injury in membranous nephropathy. J Am Soc Nephrol 2005; 16 (5): 1195-1204

68. Couser WG, Nangaku M. Cellular and molecular biology of membranous nephropathy. J Nephrol 2006; 19 (6): 699-705

69. Topham PS, Haydar SA, Kuphal R et al. Complement-mediated injury reversibly disrupts glomerular epithelial cell actin microfilaments and focal adhesions. Kidney Int 1999; 55 (5): 1763-1775

70. Yuan H, Takeuchi E, Taylor GA et al. Nephrin dissociates from actin, and its expression is reduced in early experimental membranous nephropathy. J Am Soc Nephrol 2002; 13 (4): 946-956

71. Saran AM, Yuan H, Takeuchi E et al. Complement mediates nephrin redistribution and actin dissociation in experimental membranous nephropathy. Kidney Int 2003; 64 (6): 2072-2078

72. Doublier S, Ruotsalainen V, Salvidio G et al. Nephrin redistribution on podocytes is a potential mechanism for proteinuria in patients with primary acquired nephrotic syndrome. Am J Pathol 2001; 158 (5): 1723-1731

73. Beck LH Jr, Bonegio RG, Lambeau G et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med 2009; 361 (1): 11-21

74. Glassock RJ Human idiopathic membranous nephropathy-a mystery solved? N Engl J Med 2009; 361 (1): 81-83

75. Ronco P, Debiec H. Antigen identification in membranous nephropathy moves toward targeted monitoring and new therapy. J Am Soc Nephrol 2010; 21 (4): 564-569

76. Lai KN, Leung JC, Chan LY et al. Podocyte injury induced by mesangial-derived cytokines in IgA nephropathy. Nephrol Dial Transplant 2009; 24 (1): 62-72

77. Li Y, Kang YS, Dai C et al. Epithelial–to-mesenchymal transition is a potential pathway leading to podocyte dysfunction and proteinuria. Am J Pathol 2008; 172 (2): 299-308

78. Reiser J, von Gersdorff G, Loos M et al. Induction of B7-1 in podocytes is associated with nephrotic syndrome. J Clin Invest 2004; 113 (10): 1390-1397

79. Banas MC, Banas B, Hudkins KL et al. TLR4 links podocytes with the innate immune system to mediate glomerular injury. J Am Soc Nephrol 2008; 19 (4): 704-713

80. D’Agati VD. Podocyte injury in focal segmental glomerulosclerosis: Lessons from animal models (a play in five acts). Kidney Int 2008; 73 (4): 399-406

81. Shankland SJ. The podocyte’s response to injury: role in proteinuria and glomerulosclerosis. Kidney Int 2006; 69(12): 2131-2147

82. Torbjornsdotter TB, Perrin NE, Jaremko GA, Berg UB. Widening of foot processes in normoalbuminuric adolescents with type 1 diabetes. Pediatr Nephrol 2005; 20 (6): 750-758

83. White KE, Bilous RW, Marshall SM et al. Podocyte number in normotensive type 1 diabetic patients with albuminuria. Diabetes 2002; 51 (10): 3083-3089

84. Meyer TW, Bennett PH, Nelson RG. Podocyte number predicts long-term urinary albumin excretion in Pima Indians with Type II diabetes and microalbuminuria. Diabetologia 1999; 42 (11): 1341-1344

85. Fioretto P, Mauer M. Histopathology of diabetic nephropathy. Semin Nephrol 2007; 27 (2): 195-207

86. Wiggins RC The spectrum of podocytopathies: a unifying view of glomerular diseases. Kidney Int 2007; 71 (12): 1205-1214

87. Patrakka J, Truggvason K. New insights into the role of podocytes in proteinuria. Nat Rev Nephrol 2009; 5 (8): 463-468

88. Reiser J, Gupta V, Kistler AD. Toward the development of podocyte-specific drugs. Kidney Int 2010; 77 (8): 662-668

89. Kriz W. Podocyte is the major culprit accounting for the progression of chronic renal disease. Microsc Res Tech 2002; 57 (4): 189-195

90. Kim YH, Goyal M, Kurnit D et al. Podocyte depletion and glomerulosclerosis have a direct relationship in the PAN-treated rat. Kidney Int 2001; 60 (3): 957-968

91. Wharram BL, Goyal M, Wiggins JE et al. Podocyte depletion causes glomerulosclerosis: diphtheria toxin-induced podocyte depletion in rats expressing human diphtheria toxin receptor transgene. J Am Soc Nephrol 2005; 16 (10): 2941-2952

92. Kretzler M. Role of podocytes in focal sclerosis: defining the point of no return. J Am Soc Nephrol 2005; 16 (10): 2830-2832

93. Fogo AB Glomerular hypertension, abnormal glomerular growth, and progression of renal diseases. Kidney Int Suppl 2000; 75: S15-21

94. Lu TC, He JC, Klotman PE. Podocytes in HIV-associated nephropathy. Nephron Clin Pract 2007; 106 (2): c67-71

95. He JC, Husain M, Sunamoto M et al. Nef stimulates proliferation of glomerular podocytes through activation of Src-dependent Stat3 and MAPK1, 2 pathways. J Clin Invest 2004; 114 (5): 643-651

96. Korgaonkar SN, Feng X, Ross MD et al. HIV-1 upregulates VEGF in podocytes. J Am Soc Nephrol 2008; 19 (5): 877-883

97. Barisoni L, Schnaper HW, Kopp JB. A proposed taxonomy for the podocytopathies: a reassessment of the primary nephrotic diseases. Clin J Am Soc Nephrol 2007; 2 (3): 529-542

98. Mathieson PW. Proteinuria and immunity – an overstated relationship? N Engl J Med 2008; 359 (23): 2492-2494

99. Mathieson PW. Podocyte actin in health, disease and treatment. Nephrol Dial Transplant 2010; 25 (6): 1772-1773

100. Yanagida-Asanuma E, Asanuma K, Kim K et al. Synaptopodin protects against proteinuria by disrupting Cdc42: IRSp53: Mena signaling complexes in kidney podocytes. Am J Pathol2007; 171 (2): 415-427

101. Asanuma K, Kim K, Oh J et al. Synaptopodin regulates the actin-bundling activity of alpha-actinin in an isoform-specific manner. J Clin Invest 2005; 115 (5): 1188-1198

102. Asanuma K, Yanagida-Asanuma E, Faul C et al. Synaptopodin orchestrates actin organization and cell motility via regulation of RhoA signalling. Nat Cell Biol 2006; 8 (5): 485-491

103. Yan K, Kudo A, Hirano H et al. Subcellular localization of glucocorticoid receptor protein in the human kidney glomerulus. Kidney Int 1999; 56 (1): 65-73

104. Xing CY, Saleem MA, Coward RJ et al. Direct effects of dexamethasone on human podocytes. Kidney Int 2006; 70 (6): 1038-1045

105. Castellino F, Heuser J, Marchetti S et al. Glucocorticoid stabilization of actin filaments: a possible mechanism for inhibition of corticotropin release. Proc Natl Acad Sci USA 1992; 89 (9): 3775-3779

106. Koukouritaki SB, Lianos EA. Glucocorticoid effect on human mesangial cell cytoskeletal proteins. J Lab Clin Med 1999; 133 (4): 378-383

107. Ranson RF, Lam NG, Hallett MA et al. Glucocorticoids protect and enhance recovery of cultured murine podocytes via actin filament stabilization. Kidney Int 2005; 68 (6): 2473-2483

108. Wada T, Pippin JW, Marshall CB et al. Dexamethasone prevents podocyte apoptosis induced by puromycin aminonucleoside: role of p53 and Bcl-2-related family proteins. J Am Soc Nephrol 2005; 16 (9): 2615-2625

109. Wada T, Pippin JW, Nangaku M, Shankland SJ. Dexamethasone’s prosurvival benefits in podocytes reguire extracellular signal-regulated kinase phosphorylation. Nephron Exp Nephrol 2008; 109 (1): e8-19

110. Wagrowska-Danilewicz M, Danilewicz M. Synaptopodin immunoexpression in steroid-responsive and steroid-resistant minimal change disease and focal segmental glomerulosclerosis. Nefrologia 2007; 27 (6): 710-715

111. Ehrich JH, Geerlings C, Zivicnjak M et al. Steroid-resistant idiopathic childhood nephrosis: overdiagnosed and undertreated. Nephrol Dial Transplant 2007; 22 (8): 2183-2193

112. Jain KK. Challenges of drug discovery for personalized medicine. Curr Opin Mol Ther 2006; 8 (6): 487-492


Рецензия

Для цитирования:


Смирнов А.В. ЛЕЧЕНИЕ ГЛОМЕРУЛОПАТИЙ ЦИКЛОСПОРИНОМ: ПРАВИЛЬНЫЙ ПОДХОД С НЕВЕРНЫМ ОБОСНОВАНИЕМ. Нефрология. 2010;14(4):9-22. https://doi.org/10.24884/1561-6274-2010-14-4-9-22

For citation:


Smirnov A.V. GLOMERULOPATHY TREATMENT BY CYCLOSPORINE: THE RIGHT APPROACH WITH THE WRONG RATIONALE. Nephrology (Saint-Petersburg). 2010;14(4):9-22. (In Russ.) https://doi.org/10.24884/1561-6274-2010-14-4-9-22

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