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      Call for Papers: Digital Platforms and Artificial Intelligence in Dementia

      Submit here by August 31, 2025

      About Dementia and Geriatric Cognitive Disorders: 2.2 Impact Factor I 4.7 CiteScore I 0.809 Scimago Journal & Country Rank (SJR)

      Call for Papers: Epidemiology of CKD and its Complications

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      About Kidney and Blood Pressure Research: 2.3 Impact Factor I 4.8 CiteScore I 0.674 Scimago Journal & Country Rank (SJR)

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      Monoclonal Gammopathy of Renal Significance: A Molecular Middle Earth between Oncology, Nephrology, and Pathology

      review-article

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          Abstract

          Background

          The renal biopsy represents a cornerstone in the definition of monoclonal gammopathy of renal significance (MGRS), helping in identifying patients with sub-detectable neoplastic clones (MGUS) that would deserve aggressive chemotherapies. However, the rising complexity of this onco-nephrology field is significantly challenging the daily work of nephrologists and nephropathologists, leading to the formation of ultra-specialized international centers with dedicated personnel/instrumentation and stressing the need for a better understanding of the underlying molecular landscape of these entities.

          Summary

          In this setting, the application of proteomic techniques, some with in situ capabilities (e.g., MALDI-MS imaging), for the investigation of the most challenging MGRS is progressively shedding light on the pathobiology of these diseases, providing new insights in the diagnosis and prognosis of these cases. This transformation is further enhanced by the application of next-generation digital pathology platforms, leading to a significant improvement of the cultural background for physicians thanks to second opinions, database and atlas creation, enhancement of diagnostic reports, with obvious repercussions for patients both in terms of turnaround time and appropriateness.

          Key Messages

          The present review is aimed at bridging the gap between clinical questions (i.e., a better characterization of MGRS) and the molecular landscape of onco-nephrology entities.

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          International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.

          S Vincent Rajkumar, Meletios A. Dimopoulos, Antonio Palumbo … (2014)
          This International Myeloma Working Group consensus updates the disease definition of multiple myeloma to include validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal failure, anaemia, and bone lesions). These changes are based on the identification of biomarkers associated with near inevitable development of CRAB features in patients who would otherwise be regarded as having smouldering multiple myeloma. A delay in application of the label of multiple myeloma and postponement of therapy could be detrimental to these patients. In addition to this change, we clarify and update the underlying laboratory and radiographic variables that fulfil the criteria for the presence of myeloma-defining CRAB features, and the histological and monoclonal protein requirements for the disease diagnosis. Finally, we provide specific metrics that new biomarkers should meet for inclusion in the disease definition. The International Myeloma Working Group recommends the implementation of these criteria in routine practice and in future clinical trials, and recommends that future studies analyse any differences in outcome that might occur as a result of the new disease definition.
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            IgG Subclasses and Allotypes: From Structure to Effector Functions

            Gestur Vidarsson, Gillian Dekkers, Theo Rispens (2014)
            Of the five immunoglobulin isotypes, immunoglobulin G (IgG) is most abundant in human serum. The four subclasses, IgG1, IgG2, IgG3, and IgG4, which are highly conserved, differ in their constant region, particularly in their hinges and upper CH2 domains. These regions are involved in binding to both IgG-Fc receptors (FcγR) and C1q. As a result, the different subclasses have different effector functions, both in terms of triggering FcγR-expressing cells, resulting in phagocytosis or antibody-dependent cell-mediated cytotoxicity, and activating complement. The Fc-regions also contain a binding epitope for the neonatal Fc receptor (FcRn), responsible for the extended half-life, placental transport, and bidirectional transport of IgG to mucosal surfaces. However, FcRn is also expressed in myeloid cells, where it participates in both phagocytosis and antigen presentation together with classical FcγR and complement. How these properties, IgG-polymorphisms and post-translational modification of the antibodies in the form of glycosylation, affect IgG-function will be the focus of the current review.
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              Guidelines for diagnosis, indications for treatment, response assessment and supportive management of chronic lymphocytic leukemia

              Emili Montserrat, Michael Keating, Peter Hillmen … (2018)
              The previous edition of the consensus guidelines of the International Workshop on Chronic Lymphocytic Leukemia (iwCLL), published in 2008, has found broad acceptance by physicians and investigators caring for patients with CLL. Recent advances including the discovery of the genomic landscape of the disease, the development of genetic tests with prognostic relevance, and the detection of minimal residual disease (MRD), coupled with the increased availability of novel targeted agents with impressive efficacy, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. These recommendations include a revised version of the iwCLL response criteria, an update on the use of MRD status for clinical evaluation, and recommendations regarding the assessment and prophylaxis of viral diseases during management of CLL.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Kidney Dis (Basel)
                Journal ID (iso-abbrev): Kidney Dis (Basel)
                Journal ID (publisher-id): KDD
                Title: Kidney Diseases
                Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                ISSN (Print): 2296-9381
                ISSN (Electronic): 2296-9357
                Publication date Collection: December 2022
                Publication date (Electronic): 2 November 2022
                Publication date PMC-release: 2 November 2022
                Volume: 8
                Issue: 6
                Pages: 446-457
                Affiliations
                [1] aDepartment of Medicine and Surgery, Pathology, ASST Monza, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy
                [2] bDepartment of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano - Bicocca, Monza, Italy
                [3] cDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
                [4] dNephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
                Author notes
                Article
                Publisher ID: kdd-0008-0446
                DOI: 10.1159/000527056
                PMC ID: 9798844
                PubMed ID: 36590677
                SO-VID: 1de09998-8e67-48d2-a12b-6ae82551883a
                Copyright © Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel
                License:

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

                History
                Date received : 8 May 2022
                Date accepted : 6 September 2022
                Date: 2022
                Page count
                Figures: 3, Tables: 1, References: 90, Pages: 12
                Funding
                This research received no external funding.
                Categories
                Subject: Review Article

                Keywords: monoclonal gammopathy of renal significance,lymphoma,multiple myeloma,renal biopsy,mass spectrometry,proteomics
                Data availability:
                Keywords: monoclonal gammopathy of renal significance, lymphoma, multiple myeloma, renal biopsy, mass spectrometry, proteomics

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