{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:48:14Z","timestamp":1760240894767,"version":"build-2065373602"},"reference-count":126,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T00:00:00Z","timestamp":1569974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Immunoglobulin A nephropathy (IgAN) is the most frequent glomerular disease worldwide and a leading cause of end-stage renal disease. Particularly challenging to the clinician is the early identification of patients at high risk of progression, an estimation of the decline in renal function, and the selection of only those that would benefit from additional immunosuppressive therapies. Nevertheless, the pathway to a better prognostication and to the development of targeted therapies in IgAN has been paved by recent understanding of the genetic and molecular basis of this disease. Merging the data from the Oxford Classification validation studies and prospective treatment studies has suggested that a disease-stratifying algorithm would be appropriate for disease management, although it awaits validation in a prospective setting. The emergence of potential noninvasive biomarkers may assist traditional markers (proteinuria, hematuria) in monitoring disease activity and treatment response. The recent landmark trials of IgAN treatment (STOP-IgAN and TESTING trials) have suggested that the risks associated with immunosuppressive therapy outweigh the benefits, which may shift the treatment paradigm of this disease. While awaiting the approval of the first therapies for IgAN, more targeted and less toxic immunotherapies are warranted. Accordingly, the targeting of complement activation, the modulation of mucosal immunity, the antagonism of B-cell activating factors, and proteasomal inhibition are currently being evaluated in pilot studies for IgAN treatment.<\/jats:p>","DOI":"10.3390\/jcm8101584","type":"journal-article","created":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T08:17:54Z","timestamp":1570004274000},"page":"1584","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Has The Time Arrived to Refine The Indications of Immunosuppressive Therapy and Prognosis in IgA Nephropathy?"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4796-4950","authenticated-orcid":false,"given":"Bogdan","family":"Obri\u0219c\u0103","sequence":"first","affiliation":[{"name":"Department of Nephrology, Fundeni Clinical Institute, 022328 Bucharest, Romania"},{"name":"Department of Uronephrology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioanel","family":"Sinescu","sequence":"additional","affiliation":[{"name":"Department of Uronephrology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Center of Uronephrology and Renal Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gener","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Fundeni Clinical Institute, 022328 Bucharest, Romania"},{"name":"Department of Uronephrology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Mircescu","sequence":"additional","affiliation":[{"name":"Department of Uronephrology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Nephrology, \u201cDr. Carol Davila\u201d Teaching Hospital of Nephrology, 010731 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/j.nephro.2018.02.010","article-title":"Treatment of IgA nephropathy: Recent advances and prospects","volume":"14","author":"Coppo","year":"2018","journal-title":"Nephrol. 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