The effectiveness of hydroxychloroquine and its effect on cell-mediated and humoral immunity in patients with immunoglobulin A nephropathy: results of a prospective controlled study


DOI: https://dx.doi.org/10.18565/nephrology.2022.4.19-26

Komissarov K.S., Nizheharodava D.B., Minchenko E.I., Ivanchik G.I., Pilotovich V.S., Zafranskaya M.M.

1) Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk, Republic of Belarus; 2) Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus; 3) First City Clinical Hospital, Minsk, Republic of Belarus; 4) International State Ecological Institute named after A.D. Sakharov, Belarusian State University, Minsk, Republic of Belarus
Objective: Evaluation of the clinical efficacy of using hydroxychloroquine (HCQ) compared with glucocorticosteroids (GCS) in patients with immunoglobulin A-nephropathy (IgAN) and the effect of the treatment on cell-mediated and humoral immunity.
Material and methods. Using flow cytometry and enzyme immunoassay methods, clinical, laboratory and immunological parameters were determined in 3 groups of patients with IgAN with glomerular filtration rate >50 ml/min and proteinuria (PU) >1 g/day: group 1 - HCQ (n=20), group 2 - GCS (n=20) and group 3 - maintenance therapy (n=12).
Results. A six-month course of HCQ reduced the PU level (P=0.03), the relative number of TNK-cells (P=0.05) and γδT-lymphocytes (p=0.01), as well as their cytotoxic profile, and also reduced the serum APRIL factor and immunoglobulin levels in patients with IgAN (P = 0.05), which led to remission in 60% of patients.
Conclusion. HCQ can be used as an effective alternative therapy in patients with IgAN.

About the Autors


Kirill S. Komissarov – Cand. Sci. (Med.), Associate Professor, Head of the Department of Nephrology, Renal Replacement Therapy and Kidney Transplantation, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology. Address: 8 Semashko st., Minsk; tel.: +(37517) 277-20-35, + (37529) 680-70-97; e-mail: kirill_ka@tut.by. ORCID: 0000-0002-2648-0642.
Daria B. Nizheharodava – Cand. Sci. (Biol.), Associate Professor, Head of the Department of Immunology and Biomedical Technologies, Research Laboratory, Belarusian Medical Academy of Postgraduate Education. Address: bldg. 3, 3 P. Brovka st., Minsk; tel.: + (37517) 390-22-32, + (37529) 608-99-94; e-mail: nzh@tut.by. ORCID: 0000-0003-1633-7487.
Elena I. Minchenko – Nephrologist, Department of Nephrology, First City Clinical Hospital. Address: 64 Independence Ave., Minsk; tel.: +(37517) 379-05-50; e-mail: elena_nefro@mail.ru. ORCID: 0000-0001-6268-7563.
Galina I. Ivanchik – Senior Researcher at the Department of Immunology and Biomedical Technologies of the Research Laboratory, Belarusian Medical Academy of Postgraduate Education. Address: Address: bldg. 3, 3 P. Brovka st., Minsk; tel. +(37517) 390-33-56; e-mail: immunology.by@gmail.com.
Valery S. Pilotovich – Dr. Sci. (Med.), Professor at the Department of Urology and Nephrology, Belarusian Medical Academy of Postgraduate Education. Address: bldg. 3, 3 P. Brovka st., Minsk; tel.: +(37517) 265-25-61; e-mail: pilotovich@mail.ru. ORCHID: 0000-0001-8256-5889.
Marina M. Zafranskaya – Dr. Sci. (Med.), Professor, Head of the Department of Immunology, International State Ecological Institute n.a. A.D. Sakharov, Belarusian State University. Address: bldg. 1, 23 Dolgobrodskaya st., Minsk; tel. + (37517) 243-00-07, + (37529) 631-25-48; e-mail: zafranskaya@gmail.com.
ORCHID: 0000-0002-8739-8300.


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