Acute glomerulonephritis occurring during immunoadsorption with staphylococcal protein A column (Prosorba(R))

Iglesias, José; D’Agati, Vivette D.; Levine, Jerrold S.

doi:10.1093/ndt/gfh525

Cited by 7 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this kind of therapy is slowly being replaced by B‐cell depletion therapies. Notably, the mode of action of immonoadsorption therapy and rarely occurring adverse effects (vasculitis, glomerulonephritis) 5 have not yet been cleared from the pathological point of view. Initially, it was suggested that immunoglobulins from plasma adsorb on a column on which protein A had been immobilized, as protein A displays a strong affinity to immunoglobulins.…”

Section: Introductionmentioning

confidence: 99%

MS characterization of apheresis samples from rheumatoid arthritis patients for the improvement of immunoadsorption therapy – a pilot study

Kienbaum

Koy

Montgomery

et al. 2009

Proteomics Clinical Apps

View full text Add to dashboard Cite

Identification of proteins from apheresis samples was performed by both SDS-PAGE and 2-D gel separation of eluted proteins from staphylococcal protein A-based immunoadsorption columns (Prosorba(®) ) followed by MS peptide mass fingerprinting and MS/MS peptide sequencing on a MALDI QIT TOF mass spectrometer. MS/MS peptide sequencing was performed in conjunction with a micro reversed phase HPLC configured with an online MALDI plate-spotting device. Apheresis treatment had been performed in three patients with longstanding therapy refractory rheumatoid arthritis. 2-D gels displayed ca. 500 spots representing proteins that were eluted from the Prosorba(®) columns. From 54 gels, a total of 1256 protein spots had been picked and yielded in the identification of 56 non-redundant proteins without counting isoforms. Proteins from the eluates belong to five major groups comprising (i) immunoglobulins (IgG, IgA, IgM heavy and light chains; about 40% of the spots), (ii) proteins involved in coagulation, (iii) HDL/LDL-associated proteins, (iv) proteins from the complement system, and (v) acute phase proteins. MS analysis showed that the full-length C3 complement protein had been cleaved upon complement activation, presumably on the column, such that the anaphylatoxin C3a was produced and released during therapy. Our results are consistent with clinical observations on both patient responses to therapy and reported adverse events. For the first time, direct molecular information has become available to support mechanistic reasoning for the principle of function of staphylococcal protein A-based immunoadsorption therapy and for the explanation of adverse events. According to our results, removal and/or modulation of immune complexes together with complement activation can be regarded as the major events that are taking place during Prosorba(®) therapy. In order to avoid complement activation and induction of an inflammatory cascade, we suggest the prevention of C3a anaphylatoxin-related reactions during immunoadsorption therapy.

show abstract

Section: Introductionmentioning

confidence: 99%

MS characterization of apheresis samples from rheumatoid arthritis patients for the improvement of immunoadsorption therapy – a pilot study

Kienbaum

Koy

Montgomery

et al. 2009

Proteomics Clinical Apps

View full text Add to dashboard Cite

show abstract

Translating basic research into clinical rheumatology

Woude

Huizinga

2008

Best Practice & Research Clinical Rheumatology

View full text Add to dashboard Cite

B cells move to centre stage: novel opportunities for autoimmune disease treatment

Browning

2006

Nat Rev Drug Discov

253

229

View full text Add to dashboard Cite

The B-cell arm of the immune system has long been appreciated for its crucial role in pathogen resistance, but in the study of many autoimmune diseases, T cells have dominated the limelight for decades. However, the development of the B-cell-depleting antibody rituximab as a lymphoma therapy has provided a tool to probe the contribution made by B cells in several immune disorders. Recently, the success of B-cell depletion with rituximab in the treatment of rheumatoid arthritis has stimulated investigation of its effects in several other immune disorders, and considerable interest in the potential of drugs that can modulate B-cell function for the treatment of such diseases in general. This article discusses the role of B cells in a range of autoimmune disorders, including rheumatoid arthritis and systemic lupus erythematosus, and analyses approaches to therapeutic B-cell manipulation.

show abstract

Acute glomerulonephritis occurring during immunoadsorption with staphylococcal protein A column (Prosorba(R))

Abstract: This case series highlights the risk of GN among patients undergoing SPA immunoadsorption. The development of GN is associated with the presence of leukocytoclastic vasculitis. Patients with RA seem to be at particular risk.

Cited by 7 publications

References 12 publications

MS characterization of apheresis samples from rheumatoid arthritis patients for the improvement of immunoadsorption therapy – a pilot study

MS characterization of apheresis samples from rheumatoid arthritis patients for the improvement of immunoadsorption therapy – a pilot study

Translating basic research into clinical rheumatology

B cells move to centre stage: novel opportunities for autoimmune disease treatment

Contact Info

Product

Resources

About