Alternative therapies and future intervention for treatment of membranous nephropathy

Semin Nephrol. 2003 Jul;23(4):362-72. doi: 10.1016/s0270-9295(03)00047-0.


Despite a multitude of investigation over the last 2 decades, the treatment of membranous nephropathy remains both controversial and suboptimal. Recent progress in the molecular pathways of inflammation and immunologic regulation holds the promise of offering futuristic alternatives and/or supplements to the standard regimen of glucocorticoids and alkylating agents. Several potential points of intervention along the path of disease development and expression have been identified: modulation of the immune response to the pathogenetic antigen; inactivation of the inflammatory pathways responsible for B and T cell activation; blockade of pathogenetic antibody formation by B and T cells; blockade of the complement cascade; blockade of lipid peroxidation of glomerular basement membrane components; and blockade of renal fibrosis resulting from proteinuria, lipiduria, and/or inflammation. These points of intervention form the basis for our discussion of such varied potential therapies for membranous nephropathy as: vaccines, inhibitors of tissue plasminogen activator, humanized monoclonal antibodies, mycophenolate mofetil, pentoxifylline, and others.

MeSH terms

  • Clinical Trials as Topic
  • Complementary Therapies / trends
  • Glomerulonephritis, Membranous / therapy*
  • Humans