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（点击👆，免费获取美国NIH基金资助项目大数据分析）狼疮性肾炎（Lupus Nephritis，简称LN）是一种由系统性红斑狼疮（SLE）引起的严重并发症，影响肾脏。系统性红斑狼疮是一种自身免疫性疾病，患者的免疫系统攻击自身组织，包括肾脏。尽管近年来在狼疮性肾炎的诊断和治疗方面取得了显著进展，但仍存在一些重要而未解决的临床问题：- 早期诊断：狼疮性肾炎在早期可能不易被诊断，因为早期症状可能并不明显或者与其他疾病相似。开发更敏感和特异的生物标志物是目前研究的重点。
- 个体化治疗：狼疮性肾炎的治疗通常需要使用免疫抑制剂和激素，但治疗效果因人而异，且可能会有严重的副作用。如何根据患者的具体情况调整治疗方案，以达到最佳疗效和最小副作用，是一个挑战。
- 治疗耐药性和复发：部分患者可能对标准治疗产生耐药性，或在治疗一段时间后病情复发。研究新的治疗方法和策略，以防止耐药性和复发，是当前的一个研究热点。
- 长期管理和监测：由于狼疮性肾炎可能导致慢性肾病甚至终末期肾病，患者需要长期的管理和监测。如何优化长期护理计划并减少患者的医疗负担，是未来需要解决的问题。
狼疮性肾炎的治疗和管理是一个多学科的挑战，需要免疫学家、肾脏病专家、风湿病学家和其他医疗专业人员共同协作，以提高诊断精度，优化治疗方案，并改善患者的长期预后。
我们仅对美国国立卫生研究院（NIH）资助的在研狼疮性肾炎相关项目进行梳理，希望给同仁们的选题思路提供一点启发。
2024年，以“Lupus Nephritis”为检索词、在题目中进行检索，美国NIH针对狼疮性肾炎的在研有29项。
一，谁获得了这些研究？
1，在研狼疮性肾炎基金最多的PI
BETH ISRAEL DEACONESS MEDICAL CENTER 的 TSOKOS, GEORGE C
CINCINNATI CHILDRENS HOSP MED CTR 的 BRUNNER, HERMINE I
SEATTLE CHILDREN'S HOSPITAL 的 JACKSON, SHAUN WILLIAM
UNIVERSITY OF HOUSTON 的 MOHAN, CHANDRA
UNIVERSITY OF CHICAGO 的 CLARK, MARCUS RAMSAY
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2，狼疮性肾炎基金最多的研究机构
贝思以色列女执事医疗中心
休斯顿大学
辛辛那提儿童医院医疗中心
西雅图儿童医院
耶鲁大学等
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二，狼疮性肾炎研究热点是什么？
狼疮性肾炎研究领域总览（根据关键词）
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狼疮性肾炎研究大的方向包括临床试验（Clinical Trails）、单细胞（Single Cell）、小鼠模型（Mouse Model）、LN患者（Human LN）、B细胞、肾移植（Kidney Transplantation）等。我们也分享在狼疮性肾炎领域的几项课题摘要，希望对同仁们有所启发。
A，Lupus nephritis: novel insights in the pathogenesis and treatment
This proposal will test the hypothesis that interaction of constituents of the immune system with kidney resident cells and the ectopically formed high endothelial venules, determines the development of inflammation and injury in the setting of LN. Corollaries of this hypothesis are that kidney resident cells can serve as gateways for the administration of targeted therapeutics for the treatment of LN and that kidney tissue pathology can be recorded with high fidelity in the urine cells of patients with LN.
There are 2 projects in this proposal: 1) Interplay between autoimmune effectors and kidney resident cells in lupus nephritis and 2) Newly formed high endothelial cells in the kidney- pathogenesis and implications in lupus nephritis.
The proposal will be supported by 3 cores: The Administrative Core will be responsible for regulatory compliance, budget management, scheduling meetings. The Nanoparticle Immune Delivery Core will be responsible for the construction of nanoparticles loaded with drugs and biologics and tagged with antibodies for cell-specific delivery. The Single Cell, Spatial Transcriptomics and Bioinformatics Core will perform single cell transcriptomics studies and will provide statistical and bioinformatics support.
B, The Pediatric Lupus Nephritis Mycophenolate Mofetil (PLUMM) Study
The principal hypothesis to be tested in this 2-arm 104-week study is that, compared to MMFBSA, MMFPK results in significantly higher rates of renal remission in children with proliferative LN. The primary endpoint is the proportion of subjects achieving at least partial renal remission (PRR) at week 26 of the study in the intention to treat population. The key secondary endpoint is achievement of complete renal remission (CRR) at week 26 of the study. Our approach will be to enroll 105 pediatric subjects, ages 8 years or older, who have been newly diagnosed with proliferative LN plus have chosen MMF for induction therapy plus tolerate oral MMF. Randomization will occur at baseline (1:1) to the MMKPK arm or the MMFBSA arm, respectively. After week 26, non-responders will be discontinued from the active study intervention, and subjects randomized at baseline to the MMFBSA arm who achieved PRR but not CRR will cross over to the MMFPK arm. Volumetric Absorptive Microsampling (VAMS) devices will be used to facilitate estimation of the exposure to mycophenolic acid (MPA) in whole blood as is needed to personalize MMF dosing in the MMFPK arm. Use of corticosteroid will be standardized and closely regulated during the study, and adherence to MMF will be monitored. Patented biomarkers will be assayed in the urine in support of the superiority of MMFPK over MMFBSA in controlling LN activity. Upon completion of this trial, we expect to have unequivocal evidence of the superiority MMFPK therapy compared to MMFBSA use, and to show that MMFPK dosage is well tolerated and has an acceptable safety profile in children. RELEVANCE: The proposed trial is relevant to public health because therapies for LN are investigated, i.e. disease complications that concern the majority of children with cSLE. In this setting, optimizing drug use promises to improve long-term disease outcomes through rapid control of kidney inflammation, while minimzing unnecessary exposures to an immunosuppressive and teratogenic medication. This is relevant to the part of NIH’s mission that pertains to fostering research in treatment; and the dissemination of information on research progress in lupus. LN is central to NIAMS Strategic Plan and its Lupus Research Agenda in pursuance of improved public health and patient-centered personalized care.如果您需要HS提供类似的选题大数据分析，可阅读下面的推文：应用这个“外挂”，他的选题思路源源不断、文章不断发表！
作者：Amber Wang；助理：ChatGPT；编辑：Jessica，微信号：Healsanq，加好友请注明理由。美国Healsan Consulting(恒祥咨询)，于2016年创建于美国首都大华府地区，专长于Healsan医学大数据分析（Healsan™）、及基于大数据的Hanson临床科研培训（HansonCR™）和医学编辑服务（MedEditing™）。主要为医生科学家、生物制药公司和医院科研处等提供分析和报告，成为诸多机构的“临床科研外挂”。点击👆；From Bench to Bedside, Healsan Paves the Path.▼ 支持基金申请和SCI论文发表，推动临床科研的创新与发展。基于Healsan™文献计量大数据的系列推文，全年安排如下；目前是美国基金解析系列。
