Despite advancements in the care of lupus nephritis, a considerable proportion of patients may respond poorly or flare while on conventional immunosuppressive agents. Studies in murine and human lupus have illustrated a pathogenic role for several cytokines by enhancing T- and B-cell activation, autoantibodies production and affecting the function of kidney resident cells, therefore supporting their potential therapeutic targeting. To this end, there is limited post-hoc randomized evidence to suggest beneficial effect of belimumab, administered on top of standard-of-care, during maintenance therapy in lupus nephritis. Type I interferon receptor blockade has yielded promising results in preliminary SLE trials yet data on renal activity are unavailable. Conversely, targeting interleukin-6 and interferon-γ both failed to demonstrate a significant renal effect. For several other targets, preclinical data are encouraging but will require confirmation. We envision that high-throughput technologies will enable accurate patient stratification, thus offering the opportunity for personalized implementation of cytokine-targeting therapies.

中文翻译：

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狼疮性肾炎中的细胞因子靶标：当前和未来前景。

尽管狼疮性肾炎的治疗有所进步，但仍有相当一部分患者在使用常规免疫抑制剂时可能反应不良或耀斑。对鼠和人狼疮的研究通过增强T细胞和B细胞活化，自身抗体产生并影响肾驻留细胞的功能，说明了几种细胞因子的致病作用，因此支持其潜在的治疗靶标。为此，只有很少的事后随机证据表明在狼疮性肾炎的维持治疗期间，贝米单抗在护理标准的基础上给予了有益效果。在初步的SLE试验中，I型干扰素受体阻滞已经产生了可喜的结果，但尚无肾脏活性的数据。反过来，靶向白介素6和干扰素-γ均未显示出明显的肾脏作用。对于其他几个目标，临床前数据令人鼓舞，但需要确认。我们设想，高通量技术将能够实现准确的患者分层，从而为细胞因子靶向疗法的个性化实施提供了机会。