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  1. Article ; Online: IgA vasculitis and anti-GBM disease: two ends of a spectrum of immune complex vasculitis.

    Salama, Alan D

    Rheumatology (Oxford, England)

    2020  Volume 59, Issue Suppl 3, Page(s) iii118–iii122

    Abstract: Two immune complex vasculitides, IgA vasculitis (IgAV) and anti-GBM disease, represent polar extremes with regard to our understanding of disease pathogenesis, standardized management protocols and outcomes. This report compares our current approach to ... ...

    Abstract Two immune complex vasculitides, IgA vasculitis (IgAV) and anti-GBM disease, represent polar extremes with regard to our understanding of disease pathogenesis, standardized management protocols and outcomes. This report compares our current approach to these uncommon entities in adults. Both diseases demonstrate degrees of small vessel necrosis and glomerular crescent formation. IgAV has an antibody response directed against unknown antigens, is often treated conservatively and has poorly studied long term renal outcomes. By contrast, anti-GBM disease presents with rapidly progressive glomerulonephritis and often results in end stage renal failure, despite intensive immunosuppression. Rarely, some cases of anti-GBM disease may be IgA predominant and bind other α-chains present in the GBM, but their clinical course is as for other anti-GBM disease patients but not IgAV, suggesting that the antigenic target rather than the antibody subclass is the critical factor in determining disease outcome. However, both conditions are associated with increased mortality in adults and result in significant chronic kidney disease and hypertension.
    MeSH term(s) Adult ; Anti-Glomerular Basement Membrane Disease/diagnosis ; Anti-Glomerular Basement Membrane Disease/immunology ; Anti-Glomerular Basement Membrane Disease/therapy ; Humans ; Immunoglobulin A ; Vasculitis/diagnosis ; Vasculitis/immunology ; Vasculitis/therapy
    Chemical Substances Immunoglobulin A
    Language English
    Publishing date 2020-04-28
    Publishing country England
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/kez540
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  2. Article ; Online: A Systematic Literature Review on the Use of Dried Biofluid Microsampling in Patients With Kidney Disease.

    Lamond, Megan K / Chetwynd, Andrew J / Salama, Alan D / Oni, Louise

    Journal of clinical laboratory analysis

    2024  Volume 38, Issue 7, Page(s) e25032

    Abstract: Background: Kidney disease is fairly unique due to the lack of symptoms associated with disease activity, and it is therefore dependent on biological monitoring. Dried biofluids, particularly dried capillary blood spots, are an accessible, easy-to-use ... ...

    Abstract Background: Kidney disease is fairly unique due to the lack of symptoms associated with disease activity, and it is therefore dependent on biological monitoring. Dried biofluids, particularly dried capillary blood spots, are an accessible, easy-to-use technology that have seen increased utility in basic science research over the past decade. However, their use is yet to reach the kidney patient population clinically or in large-scale discovery science initiatives. The aim of this study was to systematically evaluate the existing literature surrounding the use of dried biofluids in kidney research.
    Methods: A systematic literature review was conducted using three search engines and a predefined search term strategy. Results were summarised according to the collection method, type of biofluid, application to kidney disease, cost, sample stability and patient acceptability.
    Results: In total, 404 studies were identified and 67 were eligible. In total, 34,739 patients were recruited to these studies with a skew towards male participants (> 73%). The majority of samples were blood, which was used either for monitoring anti-rejection immunosuppressive drug concentrations or for kidney function. Dried biofluids offered significant cost savings to the patient and healthcare service. The majority of patients preferred home microsampling when compared to conventional monitoring.
    Conclusion: There is an unmet need in bringing dried microsampling technology to advance kidney disease despite its advantages. This technology provides an opportunity to upscale patient recruitment and longitudinal sampling, enhance vein preservation and overcome participation bias in research.
    MeSH term(s) Humans ; Dried Blood Spot Testing/methods ; Kidney Diseases/blood ; Kidney Diseases/diagnosis ; Male
    Language English
    Publishing date 2024-03-25
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 645095-7
    ISSN 1098-2825 ; 0887-8013
    ISSN (online) 1098-2825
    ISSN 0887-8013
    DOI 10.1002/jcla.25032
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  3. Article ; Online: Bridging the 13-Year Evidence Gap: A Time for Age-Inclusive Research.

    Oni, Louise / Smith, Rona / Salama, Alan D / Barratt, Jonathan / Trachtman, Howard / Saleem, Moin

    Journal of the American Society of Nephrology : JASN

    2024  Volume 35, Issue 4, Page(s) 502–504

    MeSH term(s) Evidence Gaps
    Language English
    Publishing date 2024-01-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.0000000000000301
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  4. Article ; Online: Relapse in Anti-Neutrophil Cytoplasm Antibody (ANCA)-Associated Vasculitis.

    Salama, Alan D

    Kidney international reports

    2019  Volume 5, Issue 1, Page(s) 7–12

    Abstract: Clinical relapses are common in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis, necessitating repeated treatment with immunosuppressive therapy, and increasing the risks of severe adverse events. Better understanding the basis of relapse ...

    Abstract Clinical relapses are common in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis, necessitating repeated treatment with immunosuppressive therapy, and increasing the risks of severe adverse events. Better understanding the basis of relapse would help stratify patients, testing the notion that more treatment may prevent development of relapse, whereas in those at low risk of disease flares, treatment minimization may be appropriate, reducing risks of adverse events, most notably infectious complications and drug toxicity. However, relapse can only occur following remission, and although defining clinical remission may seem straightforward, there is evidence in many remission patients of persistent inflammatory and immunological activity, at levels above those found in healthy individuals. This suggests that we may not truly be achieving disease remission in many patients and these persistent responses may set the patient up for subsequent disease flares. Understanding the underlying pathophysiological basis of disease activity and remission is paramount to help define better biomarkers of relapse, which should positively affect adverse events and patient outcomes.
    Language English
    Publishing date 2019-10-24
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2019.10.005
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  5. Article ; Online: Genetics and pathogenesis of small-vessel vasculitis.

    Salama, Alan D

    Best practice & research. Clinical rheumatology

    2018  Volume 32, Issue 1, Page(s) 21–30

    Abstract: Small-vessel vasculitides are uncommon autoimmune diseases characterised by inflammation and necrosis of arterioles, capillaries and venules, frequently described as various (previously eponymous) clinical syndromes. Some are associated with vessel wall ... ...

    Abstract Small-vessel vasculitides are uncommon autoimmune diseases characterised by inflammation and necrosis of arterioles, capillaries and venules, frequently described as various (previously eponymous) clinical syndromes. Some are associated with vessel wall immune complex deposition, whereas others are pauci-immune but paradoxically often associated with circulating anti-neutrophil cytoplasmic antibodies (ANCA). Most is known about the pathogenesis of the pauci-immune ANCA-associated syndromes, which are gradually becoming better understood with regard to their genetic predisposition and the critical pathways mediating disease initiation, as well as their particular phenotypic features. Through better understanding of key cellular and molecular players, we have been able to develop novel biomarkers and treatment strategies, which should translate to improved diagnostics, treatment protocols and, ultimately, better patient outcomes. These conditions are treatable but not yet curable, although it is clear that patients may follow different disease courses, which for some include restoration of their pre-morbid immune status.
    MeSH term(s) Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/genetics ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/pathology ; Humans
    Language English
    Publishing date 2018-11-17
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2052323-3
    ISSN 1532-1770 ; 1521-6942
    ISSN (online) 1532-1770
    ISSN 1521-6942
    DOI 10.1016/j.berh.2018.10.002
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  6. Article: Lupus Nephritis and Chronic Kidney Disease.

    Salama, Alan D / Caplin, Ben

    The Journal of rheumatology

    2020  Volume 47, Issue 9, Page(s) 1303–1304

    MeSH term(s) Humans ; Kidney Failure, Chronic ; Lupus Nephritis ; Renal Dialysis ; Renal Insufficiency, Chronic
    Language English
    Publishing date 2020-08-29
    Publishing country Canada
    Document type Editorial ; Comment
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.200566
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  7. Article ; Online: Binding Truths: Seronegative Anti-Glomerular Basement Membrane Disease Mediated by IgM Anti-Glomerular Basement Membrane Antibodies.

    Antonelou, Marilina / Horsley, Harry / Heptinstall, Lauren / Harber, Mark / Salama, Alan D

    Kidney international reports

    2023  Volume 8, Issue 5, Page(s) 1117–1120

    Language English
    Publishing date 2023-03-06
    Publishing country United States
    Document type Case Reports
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2023.02.1091
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  8. Article ; Online: Coaxing Anti-Inflammatory Granulocytes to Prevent Ischemic Kidney Injury: A Fine Balance.

    Salama, Alan D / Little, Mark A

    Journal of the American Society of Nephrology : JASN

    2020  Volume 31, Issue 4, Page(s) 668–670

    MeSH term(s) Anti-Inflammatory Agents ; Granulocyte Colony-Stimulating Factor ; Granulocytes ; Humans ; Kidney ; Myeloid-Derived Suppressor Cells ; Neutrophils ; Reperfusion Injury
    Chemical Substances Anti-Inflammatory Agents ; Granulocyte Colony-Stimulating Factor (143011-72-7)
    Language English
    Publishing date 2020-03-04
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2020020146
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  9. Article ; Online: Steroids as treatment for glomerulonephritis: time for a rethink.

    Hendra, Heidy / Salama, Alan D

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2020  Volume 37, Issue 7, Page(s) 1212–1217

    Abstract: Glucocorticoids have been a cornerstone of treatment for inflammatory and autoimmune kidney diseases for almost 70 years, yet it is fair to say, we still do not know how 'best' to use them. Significant adverse events are associated with their continued ... ...

    Abstract Glucocorticoids have been a cornerstone of treatment for inflammatory and autoimmune kidney diseases for almost 70 years, yet it is fair to say, we still do not know how 'best' to use them. Significant adverse events are associated with their continued use, which contribute to premature patient mortality. Steroid avoidance or minimization is possible and has been tested in various glomerular diseases, as a result of novel agents or innovative regimens using established therapeutics. It is now time to seriously address our use of steroids and educate physicians on better ways of managing inflammatory kidney diseases.
    MeSH term(s) Glomerulonephritis/drug therapy ; Glomerulonephritis, IGA ; Humans ; Kidney ; Steroids/therapeutic use
    Chemical Substances Steroids
    Language English
    Publishing date 2020-12-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfaa267
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  10. Article ; Online: The Case | Unexplained inflammation after treatment for granulomatosis with polyangiitis.

    Hendra, Heidy / Mahalingasivam, Viyaasan / Salama, Alan D / Burns, Aine

    Kidney international

    2021  Volume 100, Issue 5, Page(s) 1147–1148

    MeSH term(s) Antibodies, Antineutrophil Cytoplasmic ; Granulomatosis with Polyangiitis/diagnosis ; Granulomatosis with Polyangiitis/drug therapy ; Humans ; Inflammation
    Chemical Substances Antibodies, Antineutrophil Cytoplasmic
    Language English
    Publishing date 2021-10-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 120573-0
    ISSN 1523-1755 ; 0085-2538
    ISSN (online) 1523-1755
    ISSN 0085-2538
    DOI 10.1016/j.kint.2021.04.014
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