MECHANISMS OF RESISTANCE TO IMMUNOSUPPRESSIVE THERAPY IN PATIENTS WITH NEPHROTIC SYNDROME

• Main Authors: S. L. Morozov, V. V. Dlin, A. R. Sadykov, A. S. Voronkova, V. S. Sukhorukov
• Format: Article
• Language: Russian
• Published: Ltd. “The National Academy of Pediatric Science and Innovation” 2017-09-01
• Series: Rossijskij Vestnik Perinatologii i Pediatrii
• Subjects: children; molecular nephropathology; nephrotic syndrome; kidneys; dna; rna; next-generation sequencing; personalized therapy; tacrolimus; cyclosporine; prednisolone
• Online Access: https://www.ped-perinatology.ru/jour/article/view/521

The present article provides a modern look at the main mechanisms of resistance to immunosuppressive therapy in patients with nephrotic syndrome. The urgency of the problem is because, in most cases, the molecular basis of steroid-resistant nephrotic syndrome is not known, which has now led to the study of the pharmacokinetic, dynamic and genetic aspects of immunosuppressive drugs used to treat nephrotic syndrome, as well as the possibility of genotyping before treatment. The article deals with mechanisms and causes of resistance to the main immunosuppressive drugs used to treat nephrotic syndrome, which fully reflects the need for further study of pharamcogenomics and pharmacokinetics of this disease. We also consider the possibility of genotyping before treatment, which in the long term will allow us to take into account the patient's genotypic characteristics for the purpose of prescribing optimal regimens for immunosuppressive therapy and for carrying out a personalized therapy for nephrotic syndrome.