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How do various therapeutic approaches for IgA nephropathy target the different stages of the four-hit hypothesis?
What is the role of the APRIL in the pathogenesis of IgA nephropathy?
Answer from: at Academic Institution
Decreased production of galactose-deficient IgA: delayed-release budesonide
Decreased glomerular inflammation from immune complex (Gd-IgA - IgG) deposition: glucocorticoids, iptacopan
Decreased glomerular scarring, hyperfiltration, proteinuria, tubulointerstitial fibrosis: RAASi, SGLT2i, DEARA l...
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Answer from: at Community Practice
Based on our mechanistic understanding and some limited biomarkers, we think that ACEI, ARB, SGLT2i, endothelin antagonists like sparsentan, and complement inhibitors like iptacopan all act on the final "Hit 4" of glomerular inflammation. This points out that Hit 4 is actually quite complex! It invo...