mTORC Pathway Activation and Effect of Sirolimus on Native Kidney Antiphospholipid Syndrome Nephropathy: A Case Report

We report a patient with active APS nephropathy lesions occurring on native kidneys, in which endothelial mTORC activation was substantiated at the molecular level. Treatment with sirolimus was shown on a repeat kidney biopsy to successfully inhibit the AKT/mTORC pathway and was associated with significant improvement in kidney function and lesions of vasculopathy. Drug tolerance was excellent during the entire follow-up. This case validates and extends previous observations in kidney transplant recipients and demonstrates that endothelial activation of the AKT/mTORC pathway occurs in the damaged renal vasculature of native kidneys in APS nephropathy. These findings further support the potential of precision medicine and the use of mTORC activation as a biomarker of disease activity and as therapeutic target in patients with APS nephropathy.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research

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Background: The presence of anti-Beta 2 glycoprotein antibodies (aB2GP1) of IgA isotype is common in patients with functional impairment of the organs in which B2GP1 is elaborated. Pretransplant IgA aB2GP1 has been associated with increased risk of thrombosis in kidney and heart transplanted patients and has also been related with early mortality after heart transplantation. Circulating immune complexes between IgA and B2GP1 (B2A-CIC) have been described in the blood of patients positive for IgA aB2GP1 with thrombotic clinical symptoms. In kidney transplanted patients, B2A-CIC is a biomarker that predicts which patients Ig...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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Source: The Rheumatologist - Category: Rheumatology Authors: Tags: Conditions SLE (Lupus) kidney kidney transplant Lupus nephritis systemic lupus erythematosus (SLE) Source Type: research
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Source: Transplantation - Category: Transplant Surgery Tags: Reviews Source Type: research
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Source: Transplantation - Category: Transplant Surgery Tags: Reviews Source Type: research
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Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
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Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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Source: Transfusion and Apheresis Science - Category: Hematology Authors: Tags: Case Report Source Type: research
aacute;lez E, Serrano A Abstract Background -Antiphospholipid syndrome (APS) is characterized by recurrent thrombosis and/or gestational morbidity in patients with antiphospholipid autoantibodies (aPL). Predictive value of the presence of aPL is low and new markers are necessary to identify aPL carriers at higher risk and take preventive measures on them.The presence of circulating immune complexes of IgA bound to Beta2-glycoprotein-I (B2A-CIC) has been associated with occurrence of acute thrombotic events (TEV). In this work we study its possible predictive value for appearance of TEV in patients who are going to...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
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Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science-General Source Type: research
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Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
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