Activin receptor ligand traps in chronic kidney disease

Purpose of review Sotatercept and luspatercept are recombinant soluble activin type-II receptor-IgG-Fc fusion proteins that are tested in clinical trials for the treatment of various types of anemias, including renal anemia. The mechanism of the action of the novel drugs is incompletely understood, but it seems to be based on the inactivation of soluble proteins of the transforming growth factor-ß (TGFß) family. This review considers pros and cons of the clinical use of the drugs in reference to the current therapy with recombinant erythropoiesis-stimulating agents (ESAs). Recent findings One or more activin type-II receptor (ActRII) ligands appear to inhibit erythroid precursors, for example growth and differentiation factor 11. Trapping of these ligands by the recombinant ActRII fusion proteins, sotatercept and luspatercept increases red blood cell numbers and hemoglobin levels in humans. Reportedly, the novel compounds were well tolerated in trials on healthy volunteers and patients suffering from anemia due to chronic kidney disease or malignancies. On approval, the drugs may prove particularly useful in patients suffering from ineffective erythropoiesis, such as in myelodysplastic syndrome, multiple myeloma or ß-thalassemia, where ESAs are of little use. Independent of their effect on erythropoiesis, ActRII ligand traps were found to exert beneficial effects on renal tissue in experimental animals. Summary ESAs are likely to remain standard of c...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

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Conclusions:In a middle-aged population-based cohort, the prevalence of a RERA index≥ 5 events/h was low (3.8%) and was not associated with negative clinical outcomes when using the currently recommended scoring criteria of the American Academy of Sleep Medicine.Citation:Ogna A, Tobback N, Andries D, Preisig M, Vollenweider P, Waeber G, Marques-Vidal P, Rubio JH, Heinzer R. Prevalence and clinical significance of respiratory effort-related arousals in the general population.J Clin Sleep Med. 2018;14(8):1339–1345.
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
Publication date: Available online 14 August 2018Source: Life SciencesAuthor(s): Leônidas Graças Mendes-Junior, Leandro Ceotto Freitas-Lima, Janaína Ribeiro Oliveira, Marcos B. Melo, Carlos Eduardo Mendes D'Angelis, Jonh David Feltenberger, Igor Viana Brandi, Bruna Mara Aparecida Carvalho, André Luiz Sena Guimarães, Alfredo Maurício Batista De Paula, Carlos Eduardo Mendes D'Angelis, Maria José Campagnole-Santos, Robson Augusto Souza Santos, Valdir Andrade Braga, Sérgio Henrique Sousa SantosAbstractDiabetic cardiomyopathy (DC) describes diabetes-associated changes in th...
Source: Life Sciences - Category: Biology Source Type: research
Publication date: Available online 14 August 2018Source: Heart &LungAuthor(s): Dong Kyu Oh, Jong-Min Song, Duk-Woo Park, Sang Young Oh, Jin-Sook Ryu, Jaewon Lee, Sang Do Lee, Jae Seung LeeAbstractBackgroundAlthough guidelines have recommended that patients with chronic thromboembolic pulmonary hypertension (CTEPH) should be managed by a multidisciplinary team (MDT), there is a lack of clinical data indicating that the MDT improves CTEPH management.ObjectivesThe study aimed to identify the effect of an MDT on CTEPH management.MethodsWe divided the study period into pre-MDT and post-MDT eras and compared the implementati...
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
AbstractTo characterize the morphological change in the right ventricle (RV) of patients with pulmonary artery hypertension (PAH) and further explore the correlation between septomarginal trabeculation (SMT) and right ventricular (RV) function, myocardial fibrosis, and exercise capacity in patients with PAH. Sixty untreated PAH patients were prospectively included from May 2016 to April 2017. All patients underwent comprehensive clinical evaluation and cardiac magnetic resonance (CMR). The area and diameter of the basal segment of SMT, and the mass of SMT were measured on cine SSFP images. Relationship between parameters o...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
Authors: Ho JS, Chilvers ER, Thillai M Abstract INTRODUCTION: Sarcoidosis is a multisystem granulomatous disease predominantly affecting the lungs, with increased risk of cardiovascular disease, pulmonary hypertension and cardiac sarcoidosis (CS), the latter due to direct granuloma infiltration. Sarcoidosis is often managed by chest physicians who need to understand the diagnostic pathways and initial management plans for patients with cardiac involvement. Areas covered: The most serious consequence of CS is sudden cardiac death due to ventricular tachyarrhythmias or complete atrioventricular block. Additional comp...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
Publication date: Available online 14 August 2018Source: Journal of Arthroscopy and Joint SurgeryAuthor(s): Ramneek Mahajan, Yugal Karkhur, V. Anil, Abhimanyu Kakralia
Source: Journal of Arthroscopy and Joint Surgery - Category: Orthopaedics Source Type: research
This article aims to examine the influencing factors on health-related quality of life (HRQOL) in middle-aged adults with hypertension. HRQOL was assessed using EQ-5D from 263 middle-aged adults (40-60 years) with hypertension who participated in the 6th Korean National Health and Nutrition Examination Survey (2014). There were statistically significant differences in health-related quality of life according to income, education, subjective health status, experience of discomfort, activity limitation, stress, and aerobic physical activity. Factors influencing on health-related quality of life in middle-aged adults with hyp...
Source: International Journal of E-Health and Medical Communications - Category: Information Technology Authors: Tags: Health Information Systems Medicine & Healthcare Source Type: research
This report will provide a contemporary review of the epidemiology, pathophysiology and management options for AF in this complex patient population.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
ConclusionsOur study revealed aberrant genetic aberrations in signaling networks that may contribute to race-specific aspects of leukemogenesis. Our results suggest the value of WES as a tool for development of individual gene signatures and gene scores for AA and EA children afflicted by B-ALL. These findings may ultimately impact disease management and contribute to the elimination of disparate outcomes in AA children with B-ALL.Graphical abstract
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionWe did not observe cardiotoxicity from bortezomib-based chemotherapy despite very intensive evaluation with multiple modalities. There was neither cumulative nor transient alterations in our metrics, suggesting that bortezomib is safe from a cardiovascular standpoint in patients free of cardiovascular disease.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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