Inhibition of the Lectin Pathway of the Complement System as a Novel Approach in the Management of IgA Vasculitis-Associated Nephritis
Haresh Selvaskandan, Chee Kay Cheung, John Dormer, David Wimbury, María Teresa Martínez, Gang Xu, Jonathan Barratt
Abstract
IgA vasculitis can present as a glomerulonephritis histologically indistinguishable from IgA nephropathy (IgAN). In IgAN, the alternative and lectin pathways mediate glomerular injury and contribute to kidney function decline. Narsoplimab is a monoclonal antibody against mannan-binding lectin serine peptidase 2 (MASP-2), a key component of the lectin pathway. It is being evaluated in a phase III trial in IgAN (NCT03608033). Histopathological similarities with IgAN suggest lectin pathway activation also occurs in IgAV-associated nephritis (IgAVN). Here, we report the first ever case of narsoplimab use for the treatment of IgAVN.
Topics & Concepts
Lectin pathwayComplement systemMedicineImmunologyGlomerulonephritisNephropathyNephritisMannan-binding lectinImmunoglobulin AFicolinLupus nephritisLectinAlternative complement pathwayVasculitisProteinase 3AntibodyKidneyImmunoglobulin GPathologyAutoantibodyInternal medicineEndocrinologyDiseaseDiabetes mellitusRenal Diseases and GlomerulopathiesComplement system in diseasesVasculitis and related conditions