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- Barratt, Jonathan, et al.
(författare)
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Budesonide delayed-release capsules to reduce proteinuria in adults with primary immunoglobulin A nephropathy
- 2023
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Ingår i: Expert Review of Clinical Immunology. - : Taylor & Francis. - 1744-666X .- 1744-8409. ; 19:7, s. 699-710
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionImmunoglobulin A nephropathy (IgAN) is characterized by mesangial deposition of immune complexes containing galactose-deficient IgA1 (Gd-IgA1). This Gd-IgA1 is believed to originate from mucosally sited B cells, which are abundant in the Peyer's patches-rich distal ileum. Nefecon is a targeted-release form of budesonide developed to act in the distal ileum, thereby exerting a direct action on the mucosal tissue implicated in the pathogenesis of the disease.Areas coveredThis review discusses IgAN pathophysiology and provides an overview of the current therapeutic landscape, focusing on Nefecon, the first drug to receive accelerated US approval and conditional EU approval for the treatment of patients with IgAN at risk of rapid disease progression.Expert opinionNefecon trial data thus far have demonstrated a promising efficacy profile, with a predictable pattern of adverse events. Treatment with Nefecon for 9 months reduces proteinuria substantially (Part A of the Phase 3 trial and the Phase 2b trial). A nearly complete prevention of deterioration of renal function has been observed at 12 months in patients at greatest risk of rapid disease progression. Long-term data from Part B of the Phase 3 study will provide 24-month data, furthering understanding of the durability of the 9-month treatment course.
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| 2. |
- Lu, Chan, et al.
(författare)
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Early-life exposure to air pollution and childhood allergic diseases : an update on the link and its implications.
- 2020
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Ingår i: Expert Review of Clinical Immunology. - 1744-666X .- 1744-8409. ; 16:8, s. 813-827
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Although mounting evidence has linked environmental factors with childhood allergies, some specific key issues still remain unclear: what is the main environmental factor? what is the critical timing window? And whether these contribute to the development of disease?AREAS COVERED: This selective review summarizes recent epidemiological studies on the association between early-life exposure to indoor/outdoor air pollution and childhood allergic diseases. A literature search was conducted in the PubMed and Web of Science for peer-reviewed articles published until April 2020. Exposure to the traffic-related air pollutant, NO2, exposure during pregnancy and early postnatal periods is found to be associated with childhood allergies, and exposure during different trimesters causes different allergic diseases. However, exposure to classical air pollutants (PM10 and SO2) also contributes to childhood allergy in developing countries. In addition, early-life exposure to indoor renovation and mold/dampness significantly increases the risk of allergy in children. A synergistic effect between indoor and outdoor air pollution is found in the development of allergic diseases.EXPERT OPINION: Early-life exposure to outdoor air pollution and indoor environmental factors plays an important role in the development of childhood allergic diseases, and the synergy between indoor and outdoor exposures increases allergy risk. The available findings support the hypothesis of the 'fetal origins of childhood allergy,' with new implications for the effective control and early prevention of childhood allergies.
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