IgA Nephropathy and Psoriatic Arthritis that Improved with Steroid Pulse Therapy and Mizoribine in Combination with Treatment for Chronic Tonsillitis and Epipharyngitis

Kaneko, Takeshi; Mii, Akiko; Fukui, Megumi; Nagahama, Kiyotaka; Shimizu, Akira; Tsuruoka, Shuichi

doi:10.2169/internalmedicine.54.3510

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…Numerous observations of patients with diagnosed IgAN suggest the involvement of pathogens of viral origin, which is also confirmed by experimental models. There is an unexpected increase in the level of TLR4 activation, which is involved in the diagnosis of exogenous bacterial factors (LPS from Gram-negative bacteria, Chlamydia pneumoniae, HSP (heat shock proteins) proteins) and endogenous origin (HSP-60, additional fibronectin A domain, low-molecular LDL fractions, acid oligosaccharides hyaluronic acid, heparan sulphate), as well as factors derived from the breakdown of host cells [107][108][109][110][111][112][113]. To fully explain kidney damage in IgAN, it is necessary to fully understand the effects of TLR4 in the development of glomerulopathy, involving both glomerular cells and circulating leukocytes.…”

Section: Iga Nephropathy (Igan)mentioning

confidence: 99%

Toll-Like Receptor as a Potential Biomarker in Renal Diseases

Mertowski

Lipa

Morawska

et al. 2020

IJMS

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One of the major challenges faced by modern nephrology is the identification of biomarkers associated with histopathological patterns or defined pathogenic mechanisms that may assist in the non-invasive diagnosis of kidney disease, particularly glomerulopathy. The identification of such molecules may allow prognostic subgroups to be established based on the type of disease, thereby predicting response to treatment or disease relapse. Advances in understanding the pathogenesis of diseases, such as membranous nephropathy, minimal change disease, focal segmental glomerulosclerosis, IgA (immunoglobulin A) nephropathy, and diabetic nephropathy, along with the progressive development and standardization of plasma and urine proteomics techniques, have facilitated the identification of an increasing number of molecules that may be useful for these purposes. The growing number of studies on the role of TLR (toll-like receptor) receptors in the pathogenesis of kidney disease forces contemporary researchers to reflect on these molecules, which may soon join the group of renal biomarkers and become a helpful tool in the diagnosis of glomerulopathy. In this article, we conducted a thorough review of the literature on the role of TLRs in the pathogenesis of glomerulopathy. The role of TLR receptors as potential marker molecules for the development of neoplastic diseases is emphasized more and more often, as prognostic factors in diseases on several epidemiological backgrounds.

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Section: Iga Nephropathy (Igan)mentioning

confidence: 99%

Toll-Like Receptor as a Potential Biomarker in Renal Diseases

Mertowski

Lipa

Morawska

et al. 2020

IJMS

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“…EAT is typically performed by rubbing the epipharyngeal area with a cotton laryngeal swab soaked with 0.5% ZnCl 2 solution daily to improve venous and lymphatic stasis [7]. There was a report that the addition of EAT to steroid pulse therapy and mizoribine was effective for improving IgA nephropathy in the native kidney [13]. Since he did not have any extra-renal manifestations, the depositions of IgA and C3 2 months after transplantation could thus have also been diagnosed as IgA nephropathy.…”

Section: Discussion/conclusionmentioning

confidence: 99%

A Kidney Transplant Recipient with Recurrent Henoch-Schönlein Purpura Nephritis Successfully Treated with Steroid Pulse Therapy and Epipharyngeal Abrasive Therapy

Fujimoto

Katayama

Nishikawa

et al. 2020

Nephron

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There is no specific treatment for recurrent Henoch-Schönlein purpura nephritis (HSPN) in a transplanted kidney. We herein report a case of a kidney transplant recipient with recurrent HSPN that was successfully treated with steroid pulse therapy and epipharyngeal abrasive therapy (EAT). A 39-year-old Japanese man developed HSPN 4 years ago and had to start hemodialysis after 2 months despite receiving steroid pulse therapy followed by oral prednisolone, plasma exchange therapy, and cyclophosphamide pulse therapy. He had undergone tonsillectomy 3 years earlier in the hopes of achieving a better outcome of a planned kidney transplantation and received a living-donor kidney transplantation from his mother 1 year earlier. Although there were no abnormalities in the renal function or urinalysis 2 months after transplantation, a routine kidney allograft biopsy revealed evidence of mesangial proliferation and cellular crescent formation. Mesangial deposition for IgA and C3 was noted, and he was diagnosed with recurrent HSPN histologically. Since the renal function and urinalysis findings deteriorated 5 months after transplantation, 2 courses of steroid pulse therapy were performed but were ineffective. EAT using 0.5% zinc chloride solution once per day was combined with the third course of steroid pulse therapy, as there were signs of chronic epipharyngitis. His renal function recovered 3 months after daily EAT and has been stable for 1.5 years since transplantation. Daily EAT continued for >3 months might be a suitable strategy for treating recurrent HSPN in cases of kidney transplantation.

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“…For these reasons, the epipharynx is prone to chronic inflammation, known as chronic epipharyngitis [2]. Chronic epipharyngitis has been described as a possible contributing factor to a wide variety of human immune-mediated diseases, including collagen diseases, glomerulonephritis, autonomic nervous disorders, and primary neurological disorders [2][3][4]. Moreover, we have recently suggested a putative link between chronic epipharyngitis and functional somatic syndrome (FSS) following human papillomavirus (HPV) vaccination [5,6].…”

Section: Introductionmentioning

confidence: 99%

Possible Mechanisms Underlying Epipharyngeal Abrasive Therapy (EAT) with ZnCl2 Solution for the Treatment of Autoimmune Diseases and Functional Somatic Syndrome

Hasegawa¹,

Inoue²,

Tanaka³

et al. 2017

J Antivir Antiretrovir

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Chronic epipharyngitis is a common latent but serious condition that may contribute to a wide range of diseases in humans, including collagen diseases, glomerulonephritis and autonomic nervous disorders. In a previous study, we presented a putative causal role of chronic epipharyngitis in the development of functional somatic symptoms and syndromes following human papillomavirus vaccination by demonstrating a significant improvement in symptoms following abrasive therapy using ZnCl 2 on the epipharynx. Since this initial study, we have expanded our clinical experience, providing epipharyngeal abrasive therapy to 988 patients with confirmed chronic epipharyngitis associated with a wide variety of clinical symptoms. These symptoms could be classified into three broad categories, namely local inflammation-referred, autoimmune-related, and neuroendocrine symptoms. Symptom alleviation was achieved in the majority of patients with repeated epipharyngeal abrasive therapy.Through an in-depth review of the literature on epipharyngeal abrasive therapy, combined with our clinical experience, we propose three mechanisms underlying the therapeutic effects of epipharyngeal abrasive therapy: the astringent anti-inflammatory effect of ZnCl 2 , a blood-letting effect that promotes removal of epipharyngeal activated lymphocytes and drainage of excess inflammatory fluids containing various antigens, cytokines or noxious substances, and a neuromodulation effect achieved through stimulation of the vagus nerve. These effects can be explained within the context of current understanding of immunology, lymphology and neuroscience.Our hypothesis-driven review provides a theoretical basis for the observed therapeutic effects of epipharyngeal abrasive therapy in ameliorating various diseases, including functional somatic symptoms and syndromes following human papillomavirus vaccination.

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IgA Nephropathy and Psoriatic Arthritis that Improved with Steroid Pulse Therapy and Mizoribine in Combination with Treatment for Chronic Tonsillitis and Epipharyngitis

Cited by 12 publications

References 18 publications

Toll-Like Receptor as a Potential Biomarker in Renal Diseases

Toll-Like Receptor as a Potential Biomarker in Renal Diseases

A Kidney Transplant Recipient with Recurrent Henoch-Schönlein Purpura Nephritis Successfully Treated with Steroid Pulse Therapy and Epipharyngeal Abrasive Therapy

Possible Mechanisms Underlying Epipharyngeal Abrasive Therapy (EAT) with ZnCl2 Solution for the Treatment of Autoimmune Diseases and Functional Somatic Syndrome

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