A 15 Y OLD MALE PRESENTS WITH 23GM OF PROTEINURIA. A COURSE OF STEROIDS LEADS TO NO IMPROVEMENT. RENAL FUNCTION IS NOW DECLINING. A KIDNEY BIOPSY IS PERFORMED. SMPDL-3B EXPRESSION on THE PODOCYTE HAS BEEN STUDIED IN ONLY THIS GLOMERULAR DISEASE.
Minimal Change 9%
FSGS 70%
Membranous GN 3%
IgA Nephropathy 1%
Immunotactoid GN 9%
IgM Nephropathy 5%
The correct answer is FSGS. It has been suggested that rituximab might treat recurrent FSGS through an unknown mechanism. Rituximab not only recognizes CD20 on B lymphocytes, but might also bind sphingomyelin phosphodiesterase acid-like 3b (SMPDL-3b) protein and regulate acid sphingomyelinase (ASMase) activity. A recent study of 41 patients at high risk for recurrent FSGS, 27 of whom were treated with rituximab at time of kidney transplant. SMPDL-3b protein, ASMase activity, and cytoskeleton remodeling were studied in cultured normal human podocytes that had been exposed to patient sera with or without rituximab.
Look at a prior post regarding this
http://www.nephronpower.com/2011/08/in-news-rituximab-targeting-podocytes.html
The correct answer is FSGS. It has been suggested that rituximab might treat recurrent FSGS through an unknown mechanism. Rituximab not only recognizes CD20 on B lymphocytes, but might also bind sphingomyelin phosphodiesterase acid-like 3b (SMPDL-3b) protein and regulate acid sphingomyelinase (ASMase) activity. A recent study of 41 patients at high risk for recurrent FSGS, 27 of whom were treated with rituximab at time of kidney transplant. SMPDL-3b protein, ASMase activity, and cytoskeleton remodeling were studied in cultured normal human podocytes that had been exposed to patient sera with or without rituximab.
Look at a prior post regarding this
http://www.nephronpower.com/2011/08/in-news-rituximab-targeting-podocytes.html
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