| Abstract | Mycophenolate mofetil (MMF) is a potential new treatment for diffuse proliferative lupus nephritis. This study examines the clinical and histopathological effects, and potential mechanisms, of combination MMF/prednisone therapy in diffuse proliferative lupus nephritis. Nine patients with diffuse proliferative lupus nephritis confirmed by renal biopsy received MMF/prednisone for six months when repeat biopsies were performed. Clinical and histopathological parameters of activity and chronicity were studied. Collagens were detected by Sirus red staining; leucocyte phenotype, osteopontin (OPN), fibrinectin (FN), alpha-smooth muscle actin (alpha-SMA) and TGF-beta1 were detected by immunohistochemistry. The changes of clinical and histopathologic parameters were assessed and compared to histopathologic indicators. Eight of the nine patients achieved clinical remission; renal function deteriorated in one. Histopathological activity indices reduced significantly (9.56 +/- 2.83 versus 5.22 +/- 1.86, P < 0.01); however, the chronicity indices did not change (3.56 +/- 1.42 versus 3.22 +/- 1.20). T-cell and monocyte/macrophage infiltration. OPN expression and the percentage of proliferative cells in both glomerulus and tubulo-interstitium decreased significantly. Other features of chronic lesions, except for glomerular collagen deposition, did not change. In conclusion, MMF/prednisone therapy was effective for our patients with proliferative lupus nephritis. The active inflammatory lesions could be ameliorated through reduction of lymphocyte and monocyte/macrophage infiltration, inhibition of cell proliferation and downregulation of adhesive molecules. However, the chronic fibrotic lesions could not be significantly reduced. |
| Authors | Lei Ding, Minghui Zhao, Wanzhong Zou, Yuchun Liu, Haiyan Wang
(Affiliation: Institute of Nephrology and Renal Unit of the First Hospital, Peking University, Beijing, PR China.)
|
| Journal | Lupus
(Lupus)
Vol. 13
Issue 2
Pg. 113-8
( 2004)
ISSN: 0961-2033 England |
| PMID | 14995004
(Publication Type: Journal Article)
|
| Chemical References |
- Actins
- Fibronectins
- Glucocorticoids
- Immunosuppressive Agents
- SPP1 protein, human
- Sialoglycoproteins
- Osteopontin
- mycophenolate mofetil
- Mycophenolic Acid
- Prednisone
- Collagen
|
| Topics |
- Actins
(analysis)
- Adolescent
- Adult
- Chronic Disease
- Collagen
(analysis)
- Drug Therapy, Combination
- Female
- Fibronectins
(analysis)
- Glucocorticoids
(administration & dosage)
- Histocytochemistry
- Humans
- Immunosuppressive Agents
(administration & dosage)
- Lupus Nephritis
(drug therapy, pathology)
- Male
- Mycophenolic Acid
(administration & dosage, analogs & derivatives)
- Osteopontin
- Prednisone
(administration & dosage)
- Sialoglycoproteins
(analysis)
|
