Targeting the tyrosine kinase signaling pathways for treatment of immune-mediated glomerulonephritis: from bench to bedside and beyond
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Published version
Author(s)
Ma, TK-W
McAdoo, SP
Tam, FWK
Type
Journal Article
Abstract
Glomerulonephritis (GN) affects patients of all ages and is an important cause of morbidity and mortality. Non-selective immunosuppressive drugs have been used in immune-mediated GN but often result in systemic side effects and occasionally fatal infective complications. There is increasing evidence from both preclinical and clinical studies that abnormal activation of receptor and non-receptor tyrosine kinase signalling pathways are implicated in the pathogenesis of immune-mediated GN. Activation of spleen tyrosine kinase (SYK), Bruton's tyrosine kinase (BTK), platelet-derived growth factor receptor (PDGFR), epidermal growth factor receptor (EGFR) and discoidin domain receptor 1 (DDR1) have been demonstrated in anti-GBM disease. SYK is implicated in the pathogenesis of ANCA-associated GN. SYK, BTK, PDGFR, EFGR, DDR1 and Janus kinase are implicated in the pathogenesis of lupus nephritis. A representative animal model of IgA nephropathy (IgAN) is lacking. Based on the results from in vitro and human renal biopsy study results, a phase II clinical trial is ongoing to evaluate the efficacy and safety of fostamatinib (an oral SYK inhibitor) in high-risk IgAN patient. Various tyrosine kinase inhibitors (TKIs) have been approved for cancer treatment. Clinical trials of TKIs in GN may be justified given their long-term safety data. In this review we will discuss the current unmet medical needs in GN treatment and research as well as the current stage of development of TKIs in GN treatment and propose an accelerated translational research approach to investigate whether selective inhibition of tyrosine kinase provides a safer and more efficacious option for GN treatment.
Date Issued
2017-01-20
Date Acceptance
2016-08-18
Citation
Nephrology Dialysis Transplantation, 2017, 32 (Suppl 1), pp.i129-i138
ISSN
1460-2385
Publisher
Oxford University Press (OUP)
Start Page
i129
End Page
i138
Journal / Book Title
Nephrology Dialysis Transplantation
Volume
32
Issue
Suppl 1
Copyright Statement
© The Author 2017. This is an Open Access article distributed under the terms of the CreativeCommonsAttribution License (http://creativecommons.org/ licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Medical Research Council (MRC)
Medical Research Council (MRC)
Kidney Research UK
Vasculitis UK
Grant Number
G0400443
G0901997
SP/MEKC/5/2014
ID 1503
Subjects
Science & Technology
Life Sciences & Biomedicine
Transplantation
Urology & Nephrology
crescentic glomerulonephritis
glomerulonephritis
IgA nephropathy
immunosuppression
lupus nephritis
tyrosine kinase
EPIDERMAL-GROWTH-FACTOR
ANCA-ASSOCIATED VASCULITIS
CHRONIC MYELOID-LEUKEMIA
CHRONIC KIDNEY-DISEASE
CHRONIC MYELOGENOUS LEUKEMIA
ANTI-GBM GLOMERULONEPHRITIS
HUMAN MESANGIAL CELLS
DOMAIN RECEPTOR 1
LUPUS NEPHRITIS
IGA NEPHROPATHY
1103 Clinical Sciences
Publication Status
Published