Guiding immunotherapy based on the oxford classification activity score in IgA nephropathy
Jingjing Nong1, Yuhong Tang1, Jiazhen Yang1
1Division of Nephrology, The First Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
Frontiers in Endocrinology
|July 8, 2026
Summary
Immunotherapy may improve proteinuria remission in IgA nephropathy (IgAN) patients. High SumMEC scores indicate a positive response to treatment, guiding personalized immunotherapy strategies.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- The Oxford Classification's role in guiding immunotherapy for IgA nephropathy (IgAN) is debated.
- Renal histology's utility in immunotherapy decisions requires further elucidation.
Purpose of the Study:
- To explore combinations of Oxford Classification activity scores for immunotherapy guidance in IgAN.
- To analyze composite pathological scores' association with immunotherapy for proteinuria remission.
Main Methods:
- Retrospective analysis of 2,389 IgAN patients post-biopsy (May 2018-Nov 2023).
- Comparison of immunosuppressive therapy vs. supportive care using propensity score matching.
- Kaplan-Meier and Cox regression analyses to assess immunotherapy's impact on proteinuria remission.
- Definition and analysis of SumMEC score (M+E+C scores) as an immunotherapy responsiveness predictor.
Main Results:
- Immunotherapy increased 12-month proteinuria remission by 22% in IgAN (HR 1.22, p=0.004).
- This benefit was significant only in patients with high SumMEC scores.
- Comparable results were observed for 6-month proteinuria remission.
Conclusions:
- Immunosuppressive agents may enhance proteinuria remission in IgA nephropathy.
- Patients with high SumMEC scores demonstrate a positive response to immunotherapy, suggesting its utility in treatment selection.
Related Concept Videos
01:26Nephrotic Syndrome II : Assessment and Medical Management
IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document any history...
01:27Tumor Immunotherapy
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
01:28Chronic Kidney Disease III: Interprofessional Care
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...