Publications by authors named "Karras A"

Introduction: C3 glomerulopathy (C3G) is a complex, chronic, ultra rare, progressive primary glomerulonephritis, resulting from alternative complement pathway overactivation, leading to kidney failure in most patients, and frequent recurrence in transplants. Iptacopan (LNP023) is an oral, proximal complement inhibitor specifically targeting factor B, that selectively inhibits the alternative complement pathway.

Methods: This was a phase 2 extension study of 26 adult patients with native kidney (cohort A), or recurrent C3G (post kidney transplantation; cohort B) receiving open label iptacopan.

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Background: The PEXIVAS (Plasma exchange and glucocorticoids in severe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis) trial showed that a reduced-dose glucocorticoid regimen (redGC) was non-inferior to a standard-dose regimen (standGC) with respect to death or end-stage kidney disease (ESKD) in patients with ANCA-associated vasculitis (AAV). However, the primary endpoint did not include disease progression or relapse, cyclophosphamide was the main induction therapy and rituximab (RTX)-treated patients tended to have a higher risk of death or ESKD with redGC. We aimed to evaluate the real-world use of redGC.

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Objectives: Antiphospholipid syndrome (APS) is an autoimmune disease combining the occurrence of thrombotic and/or obstetric events with the persistent presence of antiphospholipid antibodies (i.e. lupus anticoagulant (LA), anti-cardiolipin (aCL) and anti-beta-2-glycoprotein I (aβ2GPI) antibodies).

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Introduction: Accurate assessment of pain severity is important for caring for patients with sickle cell disease (SCD). The Brief Pain Inventory was developed to address limitations of previous pain-rating metrics and is available in a short form (BPI-SF). However, the BPI-SF is a self-report scale dependent on patient comprehension and interpretation of items.

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Article Synopsis
  • Early diagnosis of kidney damage after lung transplantation is crucial due to its negative impact on patient prognosis.
  • A study analyzed 100 kidney biopsies from lung transplant patients, finding that chronic renal dysfunction was the main reason for biopsy, revealing a variety of chronic kidney lesions.
  • Key factors linked to the risk of progressing to end-stage renal disease included postoperative dialysis, high levels of proteinuria, and significant glomerulosclerosis, highlighting the need for timely nephrologist referrals.
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Background: Epstein-Barr virus (EBV) is a herpesvirus linked to nine different human tumors and lymphoproliferative disorders. Immunosuppression promotes EBV-driven malignancies. The most frequent EBV-induced malignancies are lymphomas and nasopharyngeal carcinoma.

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Introduction: The objective of this study was to describe kidney involvement in patients with myelodysplastic syndromes (MDS), their treatments, and outcomes.

Methods: We conducted a multicenter retrospective study in seven centers, identifying MDS patients with acute kidney injury (AKI), chronic kidney disease (CKD), and urine abnormalities.

Results: Fifteen patients developed a kidney disease 3 months after MDS diagnosis.

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Objectives: Avacopan, a selective C5aR1 inhibitor, recently emerged as a glucocorticoid (GCs) sparing agent in ANCA-associated vasculitis (AAV). We aim to evaluate the tolerance and efficacy of avacopan given outside randomized clinical trials or with severe kidney involvement.

Methods: In this multicentre retrospective study, we reviewed the clinical charts of patients with AAV and contraindication to high dose of GCs who received avacopan 30 mg b.

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Key Points: We evidenced terminal pathway activation (C5b-9 deposits) in most of the glomeruli on kidney biopsy of C3 glomerulopathy. The amount of C5b-9 deposits correlated with disease prognosis in C3 glomerulopathy. Increased terminal pathway activation was found predominantly in a subgroup exhibiting an immuno-fibroblastic signature.

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Kidney Biopsy (KB) is a crucial diagnostic tool in the field of renal diseases and is routinely performed in nephrology departments. A previous survey conducted by the Société Francophone de Néphrologie Dialyse Transplantation (SFNDT) revealed significant disparities in clinical practices, sometimes conflicting with the existing literature and recently published recommendations. In response, the SFNDT wished to promote the development of best practice guidelines, under the auspices of the French National Authority for Health (HAS), to establish a standardized framework for performing kidney biopsies in France.

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Article Synopsis
  • Complement 3 glomerulopathy (C3G) is a rare kidney disease caused by issues with the immune system, and iptacopan is being tested as a potential treatment in a study examining its effectiveness and safety.
  • In a phase 2 clinical trial with 27 patients, those with native C3G saw a 45% reduction in protein in their urine, while kidney transplant recipients had a significant decrease in C3 deposits in their biopsies after 84 days of treatment.
  • Overall, iptacopan showed promising results in improving kidney function and safety, as it normalized certain complement levels and had manageable side effects, with no reported deaths during the study.
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In the evolving landscape of Industry 4.0, the convergence of peer-to-peer (P2P) systems, LoRa-enabled wireless sensor networks (WSNs), and distributed hash tables (DHTs) represents a major advancement that enhances sustainability in the modern agriculture framework and its applications. In this study, we propose a P2P Chord-based ecosystem for sustainable and smart agriculture applications, inspired by the inner workings of the Chord protocol.

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Objectives: Neutrophils play a key role in ANCA-associated vasculitis, both as targets of autoimmunity and as facilitators of vascular damage. In granulomatosis with polyangiitis (GPA), the data regarding the production of reactive oxygen species (ROS) in neutrophils are unclear. Further, recent data suggests that ROS production could have an anti-inflammatory effect through the regulation of inflammasomes and IL-1-related cytokines.

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Article Synopsis
  • - The study aimed to compare how effective and safe different treatment schedules with azathioprine (AZA) and rituximab (RTX) are in preventing relapses in patients with ANCA-associated vasculitis who are in complete remission.
  • - Researchers conducted trials that compared 18-month fixed RTX to AZA, 18-month fixed RTX to 18-month tailored RTX, and extended 36-month RTX therapy versus placebo, tracking patient outcomes over 84 months.
  • - Findings indicated that the 18-month fixed RTX regimen was significantly better at preventing major relapses compared to AZA and the tailored RTX approach, leading to a higher remission rate at the 84-month mark.
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A high prevalence of chronic kidney disease (CKD) occurs in patients with myeloproliferative neoplasms (MPN). However, MPN-related glomerulopathy (MPN-RG) may not account for the entirety of CKD risk in this population. The systemic vasculopathy encountered in these patients raises the hypothesis that vascular nephrosclerosis may be a common pattern of injury in patients with MPN and with CKD.

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Article Synopsis
  • Autophagy plays a crucial role in protecting podocytes from damage in diabetic kidney disease (DKD), and restoring this process could help mitigate DKD progression.
  • * The study identifies a mechanism where TRPC6 induces calpain activation in podocytes, impairing their autophagy and leading to increased injury and DKD severity.
  • *Inhibition of calpain can restore podocyte autophagy and protect kidney function, suggesting potential therapeutic targets for treating DKD.*
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