Myeloma kidney: Toward its prevention - With new insights from in vitro and in vivo models of renal injury

ŞENGÜL Ş., Li M., Batuman V.

Journal of Nephrology, cilt.22, sa.1, ss.17-28, 2009 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 22 Sayı: 1
  • Basım Tarihi: 2009
  • Dergi Adı: Journal of Nephrology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.17-28
  • Anahtar Kelimeler: Endocytosis, Epithelial-mesenchymal transformation, Megalin/cubilin, Mitogen-activated protein kinases, NF-kappa B, PACAP38, CYCLASE-ACTIVATING POLYPEPTIDE, IMMUNOGLOBULIN LIGHT-CHAINS, TAMM-HORSFALL GLYCOPROTEIN, ADULT FANCONI-SYNDROME, BENCE-JONES PROTEINS, MULTIPLE-MYELOMA, CAST NEPHROPATHY, DEPOSITION DISEASE, LONG-TERM, MONOCLONAL GAMMOPATHY
  • Ankara Üniversitesi Adresli: Evet

Özet

Renal involvement in patients with multiple myeloma complicates their treatment and shortens their life span. The main renal lesion is predominantly a tubulointerstitial disease characterized by fibrosis, frequently associated with light chain-containing casts. At present there is no effective treatment for kidney disease associated with multiple myeloma. Recent research highlights the importance of interactions between myeloma light chains and proximal tubule epithelial cells in the pathogenesis of myeloma kidney. Dissecting the cellular and molecular events has identified novel avenues for potential treatment. Among these, pituitary adenylate cyclase-activating polypeptide-38 (PACAP38), a pituitary immune-modulating peptide, has emerged as a promising novel therapy. PACAP38 prevented light chain-induced renal injury patterns in vitro, and in experimental animals in vivo. Further clinical studies are necessary to establish the usefulness of these novel therapies in preserving the kidney function in patients with multiple myeloma. © Società Italiana di Nefrologia.