狼疮肾炎的临床研究进展_West China Medical Journal

Authors：

方明 ,  艾儒棣

Corresponding author：

艾儒棣, Email: fangming1220@gmail.com

Keywords：

狼疮肾炎; 发病机制; 治疗

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【摘要】狼疮肾炎（lupus nephritis，LN）是影响系统性红斑狼疮患者远期预后的主要因素之一。本文回顾性地探讨了近五年国内外LN的病理研究进展，包括发病机制和分型研究。同时，文章也讨论了各种治疗方案和新兴药物剂型。尽管LN的治疗已取得了许多进步，但仍然存在很多困难，需要进一步的研究。

Citation： 方明,艾儒棣. 狼疮肾炎的临床研究进展. West China Medical Journal, 2010, 25(7): 1377-1381. doi: Copy

1.	Singh S, Saxena R. Lupus nephritis[J]. American Journal of Medical Science, 2009, 337(6): 451-460.
2.	Tang S, Liu S, Lai K. Pathogenesis of lupus nephritis: an update[J]. Nephrology, 2005, 10(2): 174-179.
3.	Waldman M, Madaio M. Pathogenic autoantibodies in lupus nephritis[J]. Lupus, 2005, 14(1): 19-24.
4.	Kubota T, Watanabe N, Kanai Y, et al. Enhancement of oxidative cleavage of DNA by the binding sties of two anti-double-stranded DNA antibodies[J]. Journal of Biological Chemistry, 1996, 271: 6555-6561.
5.	Morel L, Rudofsky U, Longmate J, et al. Polygenic control of susceptibility to murine systemic lupus erythematosus[J]. Immunity, 1994, 1: 219-229.  [6]Lauwerys B, Wakeland E. Genetics of lupus nephritis[J]. Lupus, 2005, 14: 2-12.
6.	Najafi C, Korbet S, Lewis E, et al. Significance of histologic patterns of glomerular injury upon long-term prognosis in severe lupus glomerulonephritis[J]. Kidney International, 2001, 59: 2156-2163.
7.	Lewis E, Schwartz M. Pathology of lupus nephritis[J]. Lupus, 2005, 14: 31-38.
8.	Houssiau F, Ginzler E. Current treatment of lupus nephritis[J]. Lupus, 2008, 17: 426-430.
9.	Houssiau F, Vasconcelos C, D’Cruz D. Immunosupressive therapy in lupus nephritis. The Euro-lupus nephritis trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamide[J]. Arthritis Rheumatology, 2002, 46: 2121-2131.
10.	Houssiau F, Vasconcelos C, D’Cruz D, et al. The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide[J]. Ann Rheum Dis, 2010, 69(1): 61-64.
11.	Lee YH, Woo JH, Choi SJ, et al. Induction and maintenance therapy for lupus nephritis: a systematic review and meta-analysis[J]. Lupus. 2010, 19(6): 703-710.
12.	Mak A, Cheak A, Tan J, et al. Mycophenolate mofetil is as efficacious as, but safer than, cyclophosphamide in the treatment of proliferative lupus nephritis: a meta-analysis and meta-regression[J]. Rheumatology(Oxford), 2009, 48(8): 944-952.
13.	Lu F, Tu Y, Peng X, et al. A prospective multicentre study of mycophenolate mofetil combined with prednisonlone as induction therapy in 213 patients with active lupus nephritis[J]. Lupus, 2008, 17: 622-629.
14.	Paydas S, Kurt C, Taskapan C, et al. The effect of mycophenolate mofetil on primary and secondary treatment of primary glomerulonephritis and lupus nephritis[J]. Int Urol Nephrol, 2009, 41: 145-152.
15.	Elyan M, Ballou S. The effectiveness and safety of mycophenolate mofetil in lupus nephritis[J]. Clin Rheumatol, 2009, 28: 835-840.
16.	Appel G, Contreras B, Dooley G. et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis[J]. J Am Soc Nephrol, 2009, 20: 1103-1112.
17.	Tang Z, Yang G, Yu C. Effects of mycophenolate mofetil for patients with crescentic lupus nephritis[J]. Nephrology(Carlton), 2008, 13: 702-707.
18.	Lau K, Ault K, Jones D, et al. Induction therapy for pediatric focal proliferative lupus nephritis: cyclophosphamide versus mycophenolate mofetil[J]. J Pediatr Health Care, 2008, 22: 282-288.
19.	Kasitanon N, Petri M, Haas M, et al. Mycophenolate mofetil as the primary treatment of membranous lupus nephritis with and without concurrent proliferative disease: a retrospective study of 29 cases[J]. Lupus, 2008, 17: 40-45.
20.	Wang J, Hu W, Xie H, et al. Induction therapies for class Ⅳ lupus nephritis with non-inflammatory necrotizing vasculopathy: mycophenolate mofetil or intravenous cyclophosphamide[J]. Lupus, 2007, 16: 707-712.
21.	Flores-Suarez L. Remission of severe relapsing or persistent lupus nephritis using mycophenolate mofetil[J]. Arch Med Res, 2006, 37: 68-73.
22.	Ginzler E, Aranow C. Mycophenolate mofetil in lupus nephritis[J]. Lupus, 2005, 14(1): 59-64.
23.	Ong L, Hooi M, Lim L, et al. Randomized controlled trial of pulse intravenous cyclophosphamide versus mycophenolate mofetil in the induction therapy of proliferative lupus nephritis[J]. Nephrology(Carlton), 2008, 10: 504-510.
24.	Cross J, Dwomoa A, Andrews P, Mycophenolate mofetil for remission induction in severe lupus nephritis[J]. Nephron Clin Pract, 2005, 100: 92-100.
25.	Kapitsinou P, Boletis J, Skopouli F, et al. Lupus nephritis: treatment with mycophenolate mofetil[J]. Rheumatology(Oxford), 2004, 43: 377-380.
26.	Chan T, Li M, Tang F, et al. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis[J]. N Engl J Med, 2000, 343: 1156-1162.
27.	Bao H, Liu Z, Xie H, Successful treatment of class V+Ⅳ lupus nephritis with multitarget therapy[J]. J Am Soc Nephrol, 2008, 19(10): 2001-2010.
28.	Lightstone L. Lupus nephritis: where are we now?[J]. Curr Opin Rheumatol. 2010, 22(3): 252-256.
29.	Pepper R, Griffith M, Kirwan C. Rituximab is an effective treatment for lupus nephritis and allows a reduction in maintenance steroids[J]. Nephrol Dial Transplant, 2009, 24(12): 3717-3723.
30.	Ramos-Casalas M, Soto M, Cuadrado M, et al. Rituximab in systemic lupus erythematosus: A systematic review of off-label use in 188 cases[J]. Lupus, 2009, 18: 767-776.
31.	Li E, Tam L, Zhu T, et al. Is combination rituximab with cyclophosphamide better than rituximab alone in the treatment of lupus nephritis?[J]Rheumatology(Oxford), 2009, 48(8): 892-898.
32.	Perfumo F, Martini A. Lupus nephritis in children[J]. Lupus, 2005, 14(1): 83-88.
33.	Wong S, Tse K, Lee T. Lupus nephritis in Chinese children--a territory-wide cohort study in Hong Kong[J]. Pediatr Nephrol, 2006, 21: 1104-1112.
34.	Opastirakul S, Chartapisak W. Infection in children with lupus nephritis receiving pulse and oral cyclophosphamide therapy[J]. Pediatr Nephrol, 2005, 20: 1750-1755.
35.	Laoprasopwattana K, Dissaneewate P, Vachvanichsanong P. Fatal infection in children with lupus nephritis treated with intravenous cyclophosphamide[J]. Pediatr Nephrol, 2009, 24: 1334-1343.
36.	Ranchin B, Fargue S, New treatment strategies for proliferative lupus nephritis: keep children in mind![J]. Lupus, 2007, 16: 684-691.
37.	Brunner H, Bishnoi A, Barron A, et al. Disease outcomes and ovarian function of childhood-onset systemic lupus erythematosus[J]. Lupus, 2006, 15: 198-206.
38.	Baskin E, Ozen S, Cakar N. The use of low-dose cyclophosphamide followed by AZA/MMF treatment in childhood lupus nephritis[J]. Pediatr Nephrol, 2010, 25(1): 111-117.

1. Singh S, Saxena R. Lupus nephritis[J]. American Journal of Medical Science, 2009, 337(6): 451-460.
2. Tang S, Liu S, Lai K. Pathogenesis of lupus nephritis: an update[J]. Nephrology, 2005, 10(2): 174-179.
3. Waldman M, Madaio M. Pathogenic autoantibodies in lupus nephritis[J]. Lupus, 2005, 14(1): 19-24.
4. Kubota T, Watanabe N, Kanai Y, et al. Enhancement of oxidative cleavage of DNA by the binding sties of two anti-double-stranded DNA antibodies[J]. Journal of Biological Chemistry, 1996, 271: 6555-6561.
5. Morel L, Rudofsky U, Longmate J, et al. Polygenic control of susceptibility to murine systemic lupus erythematosus[J]. Immunity, 1994, 1: 219-229.  [6]Lauwerys B, Wakeland E. Genetics of lupus nephritis[J]. Lupus, 2005, 14: 2-12.
6. Najafi C, Korbet S, Lewis E, et al. Significance of histologic patterns of glomerular injury upon long-term prognosis in severe lupus glomerulonephritis[J]. Kidney International, 2001, 59: 2156-2163.
7. Lewis E, Schwartz M. Pathology of lupus nephritis[J]. Lupus, 2005, 14: 31-38.
8. Houssiau F, Ginzler E. Current treatment of lupus nephritis[J]. Lupus, 2008, 17: 426-430.
9. Houssiau F, Vasconcelos C, D’Cruz D. Immunosupressive therapy in lupus nephritis. The Euro-lupus nephritis trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamide[J]. Arthritis Rheumatology, 2002, 46: 2121-2131.
10. Houssiau F, Vasconcelos C, D’Cruz D, et al. The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide[J]. Ann Rheum Dis, 2010, 69(1): 61-64.
11. Lee YH, Woo JH, Choi SJ, et al. Induction and maintenance therapy for lupus nephritis: a systematic review and meta-analysis[J]. Lupus. 2010, 19(6): 703-710.
12. Mak A, Cheak A, Tan J, et al. Mycophenolate mofetil is as efficacious as, but safer than, cyclophosphamide in the treatment of proliferative lupus nephritis: a meta-analysis and meta-regression[J]. Rheumatology(Oxford), 2009, 48(8): 944-952.
13. Lu F, Tu Y, Peng X, et al. A prospective multicentre study of mycophenolate mofetil combined with prednisonlone as induction therapy in 213 patients with active lupus nephritis[J]. Lupus, 2008, 17: 622-629.
14. Paydas S, Kurt C, Taskapan C, et al. The effect of mycophenolate mofetil on primary and secondary treatment of primary glomerulonephritis and lupus nephritis[J]. Int Urol Nephrol, 2009, 41: 145-152.
15. Elyan M, Ballou S. The effectiveness and safety of mycophenolate mofetil in lupus nephritis[J]. Clin Rheumatol, 2009, 28: 835-840.
16. Appel G, Contreras B, Dooley G. et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis[J]. J Am Soc Nephrol, 2009, 20: 1103-1112.
17. Tang Z, Yang G, Yu C. Effects of mycophenolate mofetil for patients with crescentic lupus nephritis[J]. Nephrology(Carlton), 2008, 13: 702-707.
18. Lau K, Ault K, Jones D, et al. Induction therapy for pediatric focal proliferative lupus nephritis: cyclophosphamide versus mycophenolate mofetil[J]. J Pediatr Health Care, 2008, 22: 282-288.
19. Kasitanon N, Petri M, Haas M, et al. Mycophenolate mofetil as the primary treatment of membranous lupus nephritis with and without concurrent proliferative disease: a retrospective study of 29 cases[J]. Lupus, 2008, 17: 40-45.
20. Wang J, Hu W, Xie H, et al. Induction therapies for class Ⅳ lupus nephritis with non-inflammatory necrotizing vasculopathy: mycophenolate mofetil or intravenous cyclophosphamide[J]. Lupus, 2007, 16: 707-712.
21. Flores-Suarez L. Remission of severe relapsing or persistent lupus nephritis using mycophenolate mofetil[J]. Arch Med Res, 2006, 37: 68-73.
22. Ginzler E, Aranow C. Mycophenolate mofetil in lupus nephritis[J]. Lupus, 2005, 14(1): 59-64.
23. Ong L, Hooi M, Lim L, et al. Randomized controlled trial of pulse intravenous cyclophosphamide versus mycophenolate mofetil in the induction therapy of proliferative lupus nephritis[J]. Nephrology(Carlton), 2008, 10: 504-510.
24. Cross J, Dwomoa A, Andrews P, Mycophenolate mofetil for remission induction in severe lupus nephritis[J]. Nephron Clin Pract, 2005, 100: 92-100.
25. Kapitsinou P, Boletis J, Skopouli F, et al. Lupus nephritis: treatment with mycophenolate mofetil[J]. Rheumatology(Oxford), 2004, 43: 377-380.
26. Chan T, Li M, Tang F, et al. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis[J]. N Engl J Med, 2000, 343: 1156-1162.
27. Bao H, Liu Z, Xie H, Successful treatment of class V+Ⅳ lupus nephritis with multitarget therapy[J]. J Am Soc Nephrol, 2008, 19(10): 2001-2010.
28. Lightstone L. Lupus nephritis: where are we now?[J]. Curr Opin Rheumatol. 2010, 22(3): 252-256.
29. Pepper R, Griffith M, Kirwan C. Rituximab is an effective treatment for lupus nephritis and allows a reduction in maintenance steroids[J]. Nephrol Dial Transplant, 2009, 24(12): 3717-3723.
30. Ramos-Casalas M, Soto M, Cuadrado M, et al. Rituximab in systemic lupus erythematosus: A systematic review of off-label use in 188 cases[J]. Lupus, 2009, 18: 767-776.
31. Li E, Tam L, Zhu T, et al. Is combination rituximab with cyclophosphamide better than rituximab alone in the treatment of lupus nephritis?[J]Rheumatology(Oxford), 2009, 48(8): 892-898.
32. Perfumo F, Martini A. Lupus nephritis in children[J]. Lupus, 2005, 14(1): 83-88.
33. Wong S, Tse K, Lee T. Lupus nephritis in Chinese children--a territory-wide cohort study in Hong Kong[J]. Pediatr Nephrol, 2006, 21: 1104-1112.
34. Opastirakul S, Chartapisak W. Infection in children with lupus nephritis receiving pulse and oral cyclophosphamide therapy[J]. Pediatr Nephrol, 2005, 20: 1750-1755.
35. Laoprasopwattana K, Dissaneewate P, Vachvanichsanong P. Fatal infection in children with lupus nephritis treated with intravenous cyclophosphamide[J]. Pediatr Nephrol, 2009, 24: 1334-1343.
36. Ranchin B, Fargue S, New treatment strategies for proliferative lupus nephritis: keep children in mind![J]. Lupus, 2007, 16: 684-691.
37. Brunner H, Bishnoi A, Barron A, et al. Disease outcomes and ovarian function of childhood-onset systemic lupus erythematosus[J]. Lupus, 2006, 15: 198-206.
38. Baskin E, Ozen S, Cakar N. The use of low-dose cyclophosphamide followed by AZA/MMF treatment in childhood lupus nephritis[J]. Pediatr Nephrol, 2010, 25(1): 111-117.

West China Medical Journal

狼疮肾炎的临床研究进展

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