Exploring Remedies for C3 Glomerulopathy (C3G): Understanding Available Therapies
Kidney condition C3 glomerulopathy (C3G) poses a challenge, affecting about 2-3 individuals per million. This rare disease results in the accumulation of protein deposits in the kidney's filtering tissues, causing impaired function and, in severe cases, leading to kidney failure.
Current treatment approaches primarily aim to maintain kidney function and subdue the immune system. Systemic treatments are recommended to suppress the body's immune response. Emerging therapies for C3G target proteins instrumental in driving the disease.
The origins of C3G can be traced to overactive parts of the immune system. Certain genes create proteins that regulate the body's complement system, a crucial component of the immune system. Alterations in these genes trigger C3G, causing excess production of C3 protein, which deposits in the kidney and damages the glomeruli.
Additionally, most C3G patients carry antibodies that impair the complement system's normal function, with some genetic links between family members noted. However, researchers do not believe the genetic changes responsible for C3G are strictly inherited.
Treatments for C3G can neither reverse nor prevent the disease. Instead, the focus is on slowing down kidney damage to preserve overall health. Clinical guidelines recommend supportive interventions, such as ACE inhibitors and ARBs, which can help prevent protein leakage into the urine and control blood pressure.
When kidney function starts to decline, immunosuppressive therapies, like mycophenolate mofetil (MMF) and glucocorticoids, are recommended. These medications help suppress the immune system.
Complement inhibitors are another treatment option, as they stop the complement system's activity. Eculizumab and ravulizumab are among the medications in this category, blocking the terminal pathway of the complement system.
Eating a diet that reduces sodium, potassium, and phosphorus, while balancing protein and healthy fats, and adjusting fluid intake is also advisable. Some patients may benefit from working with a dietitian to create a personalized meal plan.
Recent advancements in treating C3G have revolved around targeting the complement system. The FDA has approved iptacopan for adults with C3G, while the VALIANT trial demonstrated positive results for pegcetacoplan. Several other complement inhibitors are being investigated in ongoing clinical trials.
These developments aim to provide improved outcomes for C3G, a challenging kidney disease.
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