An update to the pathogenesis for monoclonal gammopathy of renal significance

Zuo, Chao; Zhu, Yuanchang; Xu, Gaosi

doi:10.1016/j.critrevonc.2020.102926

Cited by 7 publications

(4 citation statements)

References 99 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Various hematological malignancies secrete monoclonal immunoglobulins and light chains, which are an important cause of kidney disease (4,18,(54)(55)(56)(57)(58). Clonal plasma cells or B-cell disorders that produce these paraproteins are collectively known as the dysproteinemias: these include multiple myeloma, lymphoproliferative disorders, and monoclonal gammopathy of renal significance(MGRS).…”

Section: Dysproteinemia-related Crystalline Nephropathiesmentioning

confidence: 99%

The Crystalline Nephropathies

Perazella

Herlitz

2021

Kidney International Reports

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

Section: Dysproteinemia-related Crystalline Nephropathiesmentioning

confidence: 99%

The Crystalline Nephropathies

Perazella

Herlitz

2021

Kidney International Reports

View full text Add to dashboard Cite

show abstract

“…Механизмы воздействия парапротеина на почеч ную ткань и структуры организма крайне разнообраз ны и пока окончательно не выяснены [22][23][24]. В силу особенностей строения и соответствующим образом измененных физикохимических свойств самой молекулы парапротеина, а также действия местных факторов аномальные ИГ и / или ЛЦ способны: 1) ока зывать токсическое влияние на клетки; 2) действовать наподобие антител по отношению к различным моле кулам; 3) активировать иммунную систему, в частности систему комплемента; 4) взаимодействовать с мезанги оцитами и другими клетками нефрона и аккумулиро ваться в виде депозитов различной структуры, например в виде амилоидных фибрилл.…”

Section: комментарийunclassified

“…В силу особенностей строения и соответствующим образом измененных физикохимических свойств самой молекулы парапротеина, а также действия местных факторов аномальные ИГ и / или ЛЦ способны: 1) ока зывать токсическое влияние на клетки; 2) действовать наподобие антител по отношению к различным моле кулам; 3) активировать иммунную систему, в частности систему комплемента; 4) взаимодействовать с мезанги оцитами и другими клетками нефрона и аккумулиро ваться в виде депозитов различной структуры, например в виде амилоидных фибрилл. При МГРЗ патологиче ское действие моноклонального ИГ может быть реа лизовано на уровне любого компартмента нефрона: клубочка, канальцев, интерстиция, сосудов [5,24,25]. Отсюда происходит и разнообразие клинических проявлений МГРЗ, которое может заключаться [26,27].…”

Section: комментарийunclassified

Kidney involvement in monoclonal gammopathies: multidisciplinary approach in oncohematology and nephrology

et al. 2020

View full text Add to dashboard Cite

The pathogenetic relationship of kidney damage and an aberrant clone of the B-cell line producing nephrotoxic monoclonal immunoglobulin underlies the concept of “monoclonal gammopathy of renal significance” (MGRS). Herein the aberrant clone does not reach the criteria necessary for initiating antitumor therapy according to oncohematological indications. MGRS is a new nosology in modern nephrology and oncohematology. Monoclonal protein’s pathological effects on kidney parenchyma result in irreversible decline of kidney function till the end stage renal disease that in line with the position of International Consensus of hematologists and nephrologists determinates critical necessity for clone specific treatment in patients with MGRS despite the absence of hematological indications for treatment initiation. Main challenge of MGRS in Russian Federation is an inaccessibility of an in-time diagnostic and appropriate treatment for the great majority of patients due to the following reasons: i) limited knowledge about the MGRS among hematologists and nephrologists; ii) lack of necessary diagnostic resources in most health-care facilities; iii) lack of approved clinical recommendations and medical economic standards for treatment of this pathological entity. In order to overcome these limitations, leading oncohematologists and nephrologists of the Russian Federation on behalf of professional communities at the end of 2019 published a conciliation document: “Monoclonal gammopathy of renal significance: Consensus of hematologists and nephrologists of Russia on the establishment of nosology, diagnostic approach and rationale for clone specific treatment”. Consensus document comprises the opinion of experts – leading nephrologists and hematologists of Russian Federation – on the problem of MGRS including the incoherence in nosology classification, diagnostics approach and rationale for clone specific treatment. Consensus document is based on conclusions and agreements reached during the conference of leading nephrologists and hematologists of Russia which was held in the framework of symposia “Plasma cell dyscrasias and lymphoproliferative diseases: modern approaches to therapy”, 15–16 of March 2019, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia. Consensus is intended to define the principal practical steps to resolve the problem of MGRS in Russian Federation that are summarized as final clauses which we present here.

show abstract

“…Недостаточная оценка клинического прогноза данного поражения -это еще одна проблема при лечении пациентов с MGRS. MGRS нельзя отнести к доброкачественным состояниям, поскольку клон -популяция клеток, возникшая из клетки-предшественницы и наследующая все ее свойства, которая способна неуклонно продуцировать моноклональный белок и поражать любую структуру нефрона (клубочка, канальцев, интерстиции, сосудов); для нее характерно наличие организованных депозитов (фибриллярных при AL-и AH-амилоидозе; микротубулярных при криоглобулинемическом и иммунотактоидном гломерулонефрите; кристаллических при проксимальной тубулопатии легких цепей с наличием или отсутствием синдрома Фанкони) или неорганизованных депозитов (при болезни отложения моноклональных иммуноглобулинов, С3-гломерулопатии, тромботической микроангиопатии) [5][6][7][8]. Все это ведет к дисфункции почечной паренхимы и, в итоге, к развитию терминальной стадии хронической болезни почек (С5 ХБП) [9].…”

unclassified

Monoclonal Gammopathy of Renal Significance: New Capabilities of Therapy

Фомина¹,

Belyaev²,

Utkina³

2021

View full text Add to dashboard Cite

Objective of the Review: To draw attention to the new capabilities of the therapy of patients with monoclonal gammopathy of renal significance (MGRS). Key Points. The article analyses and systematises available information on possible therapies of MGRS. This condition adversely affects the quality of a patient’s life, causes renal parenchyma dysfunction and terminal chronic kidney disease. Special attention is paid to cooperation between hematologists and nephrologists in management of such patients. We describe the capabilities of the modern cloneoriented therapy, advantages and disadvantages of chemotherapeutic agents used. Conclusion. Currently, the preferred approach to management of patients with MGRS is close cooperation between hematologists and nephrologists in order to personalize therapy taking into account clinical course of the disease and concomitant pathologies. Keywords: monoclonal gammopathy of renal significance, clone-oriented therapy, monoclonal protein.

show abstract

An update to the pathogenesis for monoclonal gammopathy of renal significance

Cited by 7 publications

References 99 publications

The Crystalline Nephropathies

The Crystalline Nephropathies

Kidney involvement in monoclonal gammopathies: multidisciplinary approach in oncohematology and nephrology

Monoclonal Gammopathy of Renal Significance: New Capabilities of Therapy

Contact Info

Product

Resources

About