| Abstract: | Summary: The purpose of this presentation was to review the recent results of immunotherapy (i.e. corticosteroids, cyclosporine A and mizoribine), in patients with IgA nephropathy. We summarized the effects of corticosteroid therapy in patients with advanced stage of IgA nephropathy in our division. These patients were divided into steroid or non-steroid (anti-platelet and/or anti-coagulation drug) therapy group. The clinical findings, 6 years after renal biopsy, were observed in this study. Mean levels of urinary protein excretion in the steroid therapy group (11 patients; 3.42 g/day) were higher than those in the non-steroid therapy group (nine patients; 1.64 g/day) at the time of renal biopsy. The mean levels of creatinine clearance (CCr) in the steroid or non-steroid therapy group were 61.2 and 78.6 mL/min, respectively. Efficacy of steroid or non-steroid therapy was similar in patients with the advanced stage of IgA nephropathy, and it appeared that the steroid therapy was not effective for patients in the advanced stage of this disease. Cyclosporine A is a fungal peptide with immunoregulatory properties inhibiting activation of both T and B cells. Recently, a new immunosuppressive agent, mizoribine has been developed in Japan. Mizoribine has a suppressive effect on antibody formation via the direct inhibition of B cell function. Koshikawa et al. reported the effect of this drug in 158 patients with steroid-resistant nephrotic syndrome in multi-center studies in Japan. Mizoribine was administered orally at 150 mg/day for 24 weeks. Efficacy of treatment with mizoribine was marked compared with that with placebo in patients with IgA nephropathy and membranous nephropathy. At present, the authors are determining the clinicopathological effects of mizoribine in ddY mice, a spontaneous animal model of IgA nephropathy. |
