Research Summaries in Kidney Diseases
James E. Balow, MD: Immunologically-Mediated Glomerular Diseases
Dr. Balow's clinical research studies focus on the pathology and treatment of proliferative and membranous forms of lupus nephritis. His program of research includes studies of experimental treatments with novel immunosuppressive drugs, including sirolimus, monoclonal antibodies, and autologous stem cell transplantation, as options for patients with severe or refractory forms of glomerulonephritis.
Allan D. Kirk, MD, PhD: Translational Research in Transplantation Tolerance
The scientific aim of this work is to develop and clinically implement strategies that allow for organ transplantation without the need for chronic immunosuppression. Particular emphasis is directed toward methods involving costimulation blockade including the CD40:CD154 pathway, peri-operative T-cell depletion, and non-myeloablative approaches toward mixed chimerism. The underlying pathophysiology of chronic allograft nephropathy is also studied with focus on factors that mediate dysregulated renal interstitial fibrosis. Small animal, large animal and human studies are performed.
Jeffrey B. Kopp, MD: Focal Segmental Glomerulosclerosis - Mechanisms and Therapy
Dr. Kopp is interested in the pathophysiology and treatment of focal segmental glomerulosclerosis (FSGS). Laboratory projects include studies of the molecular and cellular mechanisms of HIV-associated FSGS and the injury response of podocytes. Natural history protocols include 1) genetic studies of FSGS, examining the frequency of podocyte gene mutations in FSGS and searching for mutations accounting for the increased frequency of FSGS among African Americans and 2) a search for biomarkers associated with progressive renal fibrosis. Clinical studies for FSGS include the following treatment protocols: for early disease, pulse oral dexamethasone; for refractory disease, oral retinoids; and for refractory disease with progressive loss of renal function, oral pirfenidone. Clinical studies for recurrent FSGS following renal transplantation include a prophylactic trial (plasma exchange) and a treatment trial (plasma exchange plus cyclophosphamide).
Roslyn B. Mannon, MD: Chronic Allograft Nephropathy – Translational Approaches to Pathogenesis and Treatment
Dr. Mannon has extensive experience in vascularized models of rat and mouse kidney and heart transplantation characterizing the immune, molecular, and physiologic responses following solid organ transplantation. These models are actively used as a translational platform for studies in ischemia and reperfusion injury and in chronic allograft nephropathy in human kidney transplant recipients cared for in studies at the NIH. Dr. Mannon serves as the Medical Director of this program, and has other clinical research interests which include bone health, hypertensive management, and improving graft outcomes following kidney transplantation.
Robert A. Star, MD: Treatment of Acute Renal Failure (ARF)
Dr. Star conducts clinical and translational research to aid in the detection and treatment of ARF. Current studies focus on developing tools to study kidney function in patients, animal models, biomarkers, and finding therapeutic agents to prevent or treat ARF. Bench studies include working with a new animal model of sepsis-induced ARF to develop diagnostic and prognostic biomarkers, MRI imaging methods, and therapeutic drugs. Current clinical studies include using proteomics methods to detect, categorize, and predict progression and response to treatment of kidney diseases.
