| 2. |
- Samnegård, Björn, et al.
(författare)
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C-peptide and captopril are equally effective in lowering glomerular hyperfiltration in diabetic rats.
- 2004
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Ingår i: Nephrol Dial Transplant. - : Oxford University Press (OUP). - 0931-0509. ; 19:6, s. 1385-91
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- 150042582004051920040921200611150931-05091962004JunNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal AssociationNephrol. Dial. Transplant.C-peptide and captopril are equally effective in lowering glomerular hyperfiltration in diabetic rats.1385-91BACKGROUND: C-peptide has been shown to reduce glomerular hyperfiltration, glomerular hypertrophy and urinary albumin excretion in type 1 diabetes, but its effect has not been compared with that of an angiotensin-converting enzyme inhibitor (ACEI) in the early stage of renal involvement in diabetes. METHODS: Glomerular filtration rate (GFR) was measured in terms of inulin clearance and renal blood flow, using ultrasound technique, in four groups of streptozotocin-induced diabetic rats before and after a 60 min infusion of C-peptide (D-Cp), captopril (D-ACEI), C-peptide and captopril (D-Cp-ACEI) or placebo (D-placebo). In addition, a non-diabetic control group was studied before and after captopril infusion (C-ACEI). RESULTS: GFR was 37-51% higher in the diabetic groups than in the control animals. GFR decreased after treatment in the D-Cp, D-ACEI and D-Cp-ACEI groups, but did not change in the D-placebo group. Blood flow increased by 26-32% in the three groups receiving captopril and by 5% in the diabetic groups treated with C-peptide alone or placebo. The increase in blood flow in the three ACEI-treated groups was significantly greater than in the D-placebo group. Filtration fraction fell significantly in all groups, but only in the combined D-Cp-ACEI group did it fall significantly more than in the D-placebo group. CONCLUSIONS: C-peptide and captopril lower diabetes-induced glomerular hyperfiltration to a similar extent, but the influence of captopril on blood flow is greater than that of C-peptide, suggesting different mechanisms of action. No statistically significant additive effects of C-peptide and captopril were shown in this acute infusion study.Department of Nephrology, Danderyd Hospital, SE-182 88 Stockholm, Sweden. bjorn.samnegard@medks.ki.seSamnegårdBjörnBJacobsonStefan HSHJohanssonBo-LennartBLEkbergKarinKIsakssonBrittaBWahrenJohnJSjöquistMatsMengComparative StudyJournal Article20040305EnglandNephrol Dial Transplant87064020Angiotensin-Converting Enzyme Inhibitors0C-Peptide62571-86-2CaptoprilIMAngiotensin-Converting Enzyme InhibitorspharmacologyAnimalsC-PeptidepharmacologyCaptoprilpharmacologyDiabetes Mellitus, ExperimentalphysiopathologyGlomerular Filtration Ratedrug effectsKidney Glomerulusdrug effectsphysiopathologyMaleRatsRats, Sprague-DawleyRegional Blood Flowdrug effects200439502004924502004Mar5ppublish1500425810.1093/ndt/gfh163gfh163
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| 3. |
- van Vollenhoven, Ronald F., et al.
(författare)
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Biopsy-verified response of severe lupus nephritis to treatment with rituximab (anti-CD20 monoclonal antibody) plus cyclophosphamide after biopsy-documented failure to respond to cyclophosphamide alone
- 2004
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Ingår i: Scandinavian Journal of Rheumatology. - : Taylor & Francis. - 0300-9742 .- 1502-7732. ; 33:6, s. 423-427
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The monoclonal anti-B cell antibody rituximab (Rituxin, Mabthera) may be of benefit in antibody-driven diseases, including systemic lupus erythematosus (SLE) nephritis.PATIENTS AND TREATMENT: Two female patients with biopsy-confirmed severe and active SLE nephritis despite treatment with cyclophosphamide (CyX) were given four rituximab infusions plus two additional CyX infusions.RESULTS: Both patients tolerated the treatment well and SLE activity improved. On repeat kidney biopsy after the combined treatment, Patient 1 showed a profound reduction of nephritis activity, and she was maintained on low-dose prednisolone only. A repeat biopsy after 1 year confirmed the sustained reduction of lupus nephritis activity. In Patient 2, rebiopsy after combined treatment also showed a significant reduction in disease activity.CONCLUSION: These cases provide histopathological documentation of a significant treatment benefit from rituximab plus CyX in two patients refractory to CyX alone. This combination is being explored further as salvage therapy for such CyX-resistant patients.
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