Nevertheless this whole area offers huge potential, not least bec

Nevertheless this whole area offers huge potential, not least because it is easy to deliver and in his article A.J. Hannan (pp. 13–25) explores these aspects of neural regeneration. While trying to recruit

new cells to sites of injury or loss is important, what is ultimately selleck kinase inhibitor needed of them is for them to make connections and integrate into existing neural networks. This is obviously complex, but if the right cells can be persuaded to replace those lost then they should have an intrinsic ability to find their right target assuming they can grow their axons to such targets. This is a problem in the adult CNS where many inhibitors to axonal growth exist [7] and has been a major issue for many diseases and regenerative therapies especially in the spinal cord – where pathway reconstitution is needed more than cell replacement. E.R. Burnside and E.J. Bradbury (pp. 26–59) in their article discuss how this has been investigated and treated in the field of spinal cord repair, which has led to the use of blocking antibodies, enzymes to breakdown the extracellular matrix and other agents designed to allow axonal growth and stability. While the recruitment of endogenous repair processes makes intuitive sense as a strategy by which to repair the

CNS, it clearly fails in most circumstances otherwise we would never see patients with neurological deficits suffering from such disorders of the CNS. Nowhere is Rapamycin chemical structure this more apparent than in the

case of chronic neurodegenerative disorders such as PD and HD. Thus in both disorders the grafting of exogenous sources of cells to replace those lost as part of the core disease process has been investigated with varying degrees of success. In the case of PD, the tissue best suited to do this selleck screening library has been the developing human foetal ventral midbrain (mesencephalon) while in HD it has been the developing human foetal ganglionic eminence. In both cases the strategy involves transplanting in the developing dopaminergic and striatal neuroblasts with the expectation that they will survive, differentiate into their mature counterparts (which have been lost in the disease process) and connect with and to the host brain and by so doing repair the brain and restore the patient back to a more normal neurological state. In the case of PD this approach has been shown to work albeit rather inconsistently [8] and G.H. Petit et al. (pp. 60–70) take us through the history of this field as well as its future prospects. They highlight the reasons why it may work as well as some of the limitations of this approach – not least the possibly that the graft may ultimately acquire the pathology of the disease it is used to treat. This theme is taken up by G. Cisbani and F. Ciccheti (pp. 71–90) who lay out the data for the failure of striatal grafts to produce significant long terms benefits in most patients with HD transplanted to date.

[59, 60] The present study reinforces the idea that the impairmen

[59, 60] The present study reinforces the idea that the impairment of protein degradation machineries has a key role for the formation of TDP-43 and FUS aggregates in ALS. Several reports describing recombinant adeno-associated virus (AAV)-mediated gene delivery of TDP-43 and FUS have been published as disease models of ALS in rodents and non-human primates.[64-68] In these, overexpression of wild type TDP-43 by AAV infection induced significant toxicity to the infected animals. However, distinct cytoplasmic aggregate BGB324 formation of TDP-43 in AAV-infected motoneurons has not been clearly demonstrated.[64-66, 68] The

present experimental approach using adenoviruses therefore appears more suitable than using AAV for induction of cytoplasmic aggregates in rodent motoneurons in vivo. It has been hypothesized that TDP-43 and FUS proteins, LY294002 in vitro known to be intrinsically aggregation-prone and contain prion-like domains, may propagate from cell to cell and evoke prion-like regional spreading in ALS,[8, 69-72] although in vivo experimental evidence is currently lacking. Similar self-propagating spread is also suggested for aggregate formation of superoxide dismutase-1 (SOD1).[70, 73] In the

present study we demonstrated aggregate formation of TDP-43 and FUS in adult rat facial motoneurons by combined adenovirus infection. Since the formation of aggregates by adenovirus infection is confined to unilateral facial nucleus, these animal models may serve an experimental opportunity to investigate whether

these TDP-43 and FUS aggregates function as seeds and propagate to other brain regions in contiguity after longer incubation periods. In conclusion, we used recombinant adenoviruses DNA ligase encoding wild type and mutant TDP-43 or FUS, and those encoding shRNAs for proteasome (PSMC1), autophagy (ATG5), and endosome/ESCRT (VPS24) systems to induce cytoplasmic aggregates in motoneurons in vitro and in vivo. Co-infections of adenovirus encoding shRNA for PSMC1, ATG5, or VPS24 with TDP-43 or FUS adenovirus enhanced cytoplasmic aggregate formation in motoneurons, suggesting that impairment of proteasome, autophagy or endosome/ESCRT systems accelerates TDP-43 and FUS pathology in ALS. We are grateful to Dr Hidenori Akutsu, National Center for Child Health and Development, Tokyo, Japan, for providing mouse ES (NCH4.3) cells. This study was supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology, Japan (JSPS KAKENHI) #24500428.

Musculoskeletal pain is a common problem after renal transplantat

Musculoskeletal pain is a common problem after renal transplantation, however an acute inflammatory arthropathy is rare. The differential diagnosis is broad and includes septic arthritis, systemic infection, crystal arthropathies, autoimmune rheumatological disorders, and medication-related adverse events. In our case, many of these differential diagnoses were excluded through supportive investigations and the temporal course of events. Infection-related arthritis is commonly due to viral infections. After recent transplantation, high-dose immunosuppression increases the risk of reactivation of quiescent viral infection and de novo viral infection in the recipient,

as well as donor-transmitted Dasatinib purchase infection. In our patient, missing a donor-transmitted infection was a significant concern, however reassuring clinical improvement with supportive investigations (negative polymerase chain reaction and serology for particular viral infections known to present with arthralgia in this population), made an infection-related arthritis highly unlikely. A medication-related adverse event proved the most likely cause of the patient’s symptoms. After transplantation, new medications including potent immunosuppressants 3-deazaneplanocin A cost are commenced simultaneously and adverse events are not uncommon. Medication-related adverse events are inevitably a diagnosis of exclusion, and as these immunosuppressants are vital for graft survival, isolation and subsequent cessation/alteration of the presumed

causative agent can be challenging and fraught with risk. Calcineurin inhibitors (CNI) including tacrolimus have been associated with a musculoskeletal pain syndrome affecting the lower limbs. Calcineurin-induced pain syndrome (CIPS) was first named in 2001 by Grotz et al. with a series of nine renal transplant recipients,[1] and more extensive reporting has occurred since. Onset is typically 3 to 12 months after transplantation. The disorder is characterized by debilitating symmetrical osteoarticular pain of the knees and feet, which persists for a number of months and is usually self-limiting. Inflammatory markers are rarely elevated. Symptoms often improve with CNI dose-reduction or cessation, and pathogenesis is hypothesized to be related to intraosseous vasoconstriction. Whilst CIPS has some features consistent with our patient’s presentation, the early onset after Pyruvate dehydrogenase transplantation and the systemic and inflammatory aspects argue against it. Several case reports have found mycophenolate mofetil to be associated with an acute inflammatory syndrome characterized by fever, arthralgia, oligoarthritis and raised inflammatory markers soon after initiation of therapy in renal transplantation or treatment for ANCA-associated vasculitis.[2] Symptoms begin 3–5 days after initiation or dose-increase of mycophenolate, and rapidly resolve with mycophenolate cessation. The pathogenesis has been attributed to a paradoxical pro-inflammatory reaction of polymorphonuclear neutrophils.

(Barns et al , 1991; Dujon et al , 2004; Dujon, 2006) Both S  ce

(Barns et al., 1991; Dujon et al., 2004; Dujon, 2006). Both S. cerevisiae and C. glabrata can produce biofilms as haploids (Whelan et al., 1984; Hawser & Douglas, 1994; Reynolds & Fink, 2001) Selleck Ensartinib and form a thin biofilm layer of budding yeasts (Seneviratne et al., 2009; Haagensen et al., 2011). Saccharomyces cerevisiae is genetically tractable and has several properties that make it a favoured model organism (Guthrie & Fink, 1991). Saccharomyces cerevisiae is rarely pathogenic (McCusker et al., 1994), has a high rate of homologous recombination and has a highly versatile DNA transformation system (Rothstein, 1983; Wach et al., 1994). Because of its use

in the food industry and as a cell biology model, it has been studied extensively. Saccharomyces cerevisiae was the first eukaryotic genome to be sequenced (Goffeau et al., 1996), making it amenable to global genetic and phenotypic analysis. In addition, both transcriptomic (DeRisi et al., 1997; Velculescu et al., 1997) and proteomic (Zhu et al., 2001) studies were first applied in S. cerevisiae. Consequently, advanced genetic tools have been developed for this fungus. Ten years ago, Reynolds

selleck kinase inhibitor and Fink introduced S. cerevisiae as a model for yeast biofilm studies (Reynolds & Fink, 2001). Biofilm formation of S. cerevisiae and its regulation are conserved in opportunistic pathogenic Candida spp. (Rigden et al., 2004; Desai et al., 2011). Hence, understanding of adherence and its regulation in S. cerevisiae contributes to our understanding of the orthologous mechanisms in Candida spp. Other properties of yeast biofilms may also be conserved, such as quorum sensing (QS) mechanisms (Chen et al., 2004; Chen & Fink, 2006) and the presence of an ECM (Hawser & Douglas, 1994; Kuthan et al., 2003). Taken together, these make S. cerevisiae an attractive model for biofilm studies. In this review, we focus on the traits common to bacterial

and pathogenic yeast biofilms that are also found in S. cerevisiae, specifically adhesion, ECM, QS, drug resistance and evolution of cell surface variation. The knowledge of molecular mechanisms for cell–cell and cell–surface adherence in S. cerevisiae is detailed second and well reviewed (Brückner & Mösch, 2011). As adhesion is essential for biofilm, environmental cues and pathways regulating adhesion are also expected to affect biofilm development. Because less is known about the molecular mechanisms for matrix formation, QS and drug resistance, the last part of the review contains a discussion of novel microscopic techniques and state-of-the-art molecular genetics that can be applied to identify and investigating factors for S. cerevisiae biofilm development. Attachment of S. cerevisiae to foreign surfaces such as polystyrene is dependent on the cell surface protein Muc1/Flo11 (Reynolds & Fink, 2001). In S.

CD38 mean fluorescence intensity (MFI) increased not only in CD14

CD38 mean fluorescence intensity (MFI) increased not only in CD14+ monocytes that became infected but also in monocytes in the same cultures that remained uninfected (Supporting Information Fig. HTS assay 4). These results indicate that exposure to HIV-1 is sufficient to cause upregulation of CD38 in peripheral blood monocytes in vitro and, taken together

with the observed effects of depleting HIV-specific IL-10+ CD8+ T cells, suggest that the latter could protect monocytes from activation by HIV-1 in vivo. Finally, we investigated whether the effects of HIV-specific IL-10+ CD8+ T cells on monocyte CD38 expression were IL-10-dependent. Treatment of CD8-depleted PBMCs with an IL-10 receptor (IL-10R) blocking antibody prior to co-culture overnight with CD8+ T cells led to a marginal

increase in monocyte CD38 expression, when compared with the effect of depleting HIV-specific IL-10+ CD8+ T cells. This could reflect incomplete receptor blockade on monocytes; alternatively, it could indicate selleck chemicals llc that this population may not mediate its effects solely through IL-10 production (Supporting Information Fig. 5). In this study, we have shown that a distinct subpopulation of HIV-specific CD8+ T cells contributes substantially to IL-10 production by PBMCs in chronic uncontrolled HIV-1 infection. The magnitude of this population was positively correlated with the magnitude of the IFN-γ response to the same HIV-1 antigens and the majority of the CD8+ T-cell subset co-produced IL-10 and IFN-γ upon short-term HIV-1 gag stimulation. However, a shift towards lone IL-10 production was associated with better virological control. Together, these observations suggest that a subset of HIV-1 gag-specific IFN-γ-secreting CD8+ T cells may have acquired the capacity to produce IL-10 in response to chronic viral replication, possibly as Erlotinib research buy a protective response to inflammation in the context

of ongoing antigenic stimulation. Their virtual absence in patients treated with an effective ART regimen is consistent with this notion, although this remains to be confirmed in a longitudinal study. Furthermore, their lack of a conventional Treg-cell phenotype contrasted with CMV-specific IL-10+ CD8+ T cells that were detected in some co-infected individuals and suggests that these populations have distinct ontogenies. Co-expression of IL-10 and IFN-γ by tissue-homing virus-specific T cells has been extensively reported in murine viral infection models and in human CD4+ T cells [11, 19, 25-28]. By contrast, human virus-specific CD8+ T-cell populations with dual IL-10-/IFN-γ-secreting capacity appear to be rare: to our knowledge, the only precedent for this is in Epstein-Barr virus (EBV) infected solid organ transplant recipients, in whom CD8+ Treg type 1 cells expressing FoxP3 could be induced in vitro by type-1-polarising DCs [11].

fumigatus were not pathogenic to the flies Besides, Toll-deficie

fumigatus were not pathogenic to the flies. Besides, Toll-deficient flies showed even greater susceptibility to zygomycetes. This suggests that TLR plays a significant role in recognition and subsequent response of zygomycetes-mediated infection. Large eaters’ in Greek are differentiated from monocytes providing the front line of host defence against bacteria, fungi and viruses.[39-43] Depending on its location throughout the body, its function varies. Alveolar macrophages (AM), residents in the lung, are playing an important role in

both the innate and the adaptive immunity in the respiratory tract.[39] AM express receptors of many kinds to initiate phagocytosis with or without opsonisation. They also can produce new proteins such as cytokines, antimicrobial peptides to aid in fighting Copanlisib ic50 against the infection.[44-46] Unfortunately, there are not many studies done on macrophage interaction with zygomycetes. Work from 1985 by Waldorf et al. [32] showed higher mortality of induced-diabetic mice with zygomycetes than that of A. fumigatus and no effect on normal mouse model was observed. This proves how a diabetic condition can play a crucial role in mucormycosis. There has Lumacaftor solubility dmso been a study of comparison between human and rat macrophages. Both

unstimulated macrophages did not inhibit Rhizopus germination. However, the activation of macrophages was successful in the presence of serum. When rat macrophages were applied, L-arginine was additionally necessary for the activation. Incubation with diabetic serum significantly reduces its capability in both human and rat.[43] An interesting study was carried out by Warris et al. [44] on proinflammatory cytokine responses of human mononuclear cells (e.g. lymphocytes, monocytes and macrophages) in co-infection with various Aspergillus species and R. oryzae. The results demonstrated that R. oryzae 17-DMAG (Alvespimycin) HCl stimulated mononuclear cells to produce more IL-6 and TNF-α than those of Aspergillus species. This result indicates that R. oryzae is more immunogenic than Aspergillus

species including A. fumigatus. A fluorescence microscopy image displaying the interaction between resting spores of L. corymbifera and murine AM from MH-S cell lines is shown in Fig. 4. For a more detailed investigation on the automated analysis of fluorescence microscopic images with this fungus, which causes systemic infection in human, please refer to Kraibooj et al. [62] published within this special issue of the journal Mycoses. Apart from PMN and macrophages, there are other cellular effectors in innate immunity such as NK cells and DC (Fig. 3). Both are known to be crucial keyplayers, which function at the intersection of innate and adaptive immunity. They control several types of microbial infections especially the viral infections and some types of tumours.

However, it must be noted that TD and TI responses are not rigidl

However, it must be noted that TD and TI responses are not rigidly compartmentalized within the B-2 and MZ/B-1 cell subsets. 20s Proteasome activity For instance,

MZ B cells also participate in TD antibody production owing to their ability to shuttle to the follicle and present antigen to T cells [[40, 41]]. Conversely, B-2 cells can initiate TI antibody responses in the intestine [[42]]. Here, we discuss recent advances in our understanding of the mechanisms by which adaptive and innate immune cells provide help to B cells. Protein antigens initiate protective antibody responses in the follicles of secondary lymphoid organs, a microenvironment that favors the interaction of B and T cells with each other as well as with antigen presenting DCs and

antigen exposing follicular dendritic cells (FDCs) (reviewed in [[7]]). After interacting with antigen through the B-cell receptor (BCR), which includes IgM and IgD (Fig. 1), naive B cells migrate GSK458 purchase to the boundary between the follicle and the outer T-cell zone [[43]]. At this location, B cells form dynamic conjugates with TFH cells, which deliver cognate B-cell help through a mechanism involving the tumor necrosis factor (TNF) family member CD40L and cytokines such as interferon-γ (IFN-γ, a cytokine also expressed by TH1 cells) and interleukin-4 (IL-4, a cytokine also expressed by TH2 cells) [[13, 14, 43, 44]]. B cells thereafter differentiate

along one of the two pathways. The follicular pathway generates Bcl6-positive germinal center B cells that further differentiate into long-lived memory B cells and plasma cells producing high-affinity antibodies, whereas the extrafollicular pathway generates Bcl6-negative blasts that further differentiate into short-lived plasma cells secreting low-affinity antibodies [[14, 45]]. After receiving activating signals from TFH cells at the border of the follicle with the T-cell zone, B cells upregulate the expression of the DNA-editing enzyme activation-induced cytidine deaminase (AID) and initiate somatic hypermutation (SHM) and class switch recombination (CSR), two Ig gene diversifying processes highly dependent on AID [[46-49]]. SHM introduces point mutations within V(D)J genes, thereby providing the structural Astemizole correlate for selection of high-affinity Ig mutants by antigen (reviewed in [[50]]). By replacing constant (C) μ, and Cδ genes, which encode IgM and IgD, respectively, with Cγ, C, or C genes, which encode IgG, IgA, or IgE, respectively, CSR provides antibodies with novel effector functions without changing antigen specificity (reviewed in [[51]]). In humans, a noncanonical form of CSR from Cμ to Cδ has also been documented in lymphoid structures associated with the upper respiratory tract and generates B cells specialized in IgD production [[52]].

pseudomallei causes approximately 20% of community acquired septi

pseudomallei causes approximately 20% of community acquired septicemia, and is associated with a 50% mortality rate. B. pseudomallei is a facultative intracellular parasite which is able to survive in phagocytic cells as well as in association with phagolysosomes (4), where it is believed that it tolerates and adapts to significant oxidative

and acidic stress. One strategy by which this organism protects itself from oxidative damage in the host cell is by inducing expression of a number of antioxidant and repair enzymes, and much of this inducible resistance depends on the oxyR gene, which governs a set of genes that constitute the oxyR regulon (5). OxyR, a dual-function regulator for repressing katG, encodes a bifunctional enzyme with both catalase and peroxidase activities. It expresses Selleck LBH589 during normal growth but activates katG during exposure to oxidative stress (6). Expression of the non-specific dpsA is also increased in response to oxidative stress through increased transcription from the upstream katG (catalase-peroxidase) promoter, which is dependent on OxyR. B. pseudomallei cells in the stationary phase are constitutively resistant to a variety of stressful conditions, including exposure to high concentrations of oxidants (7). This

increased resistance is controlled by the alternative sigma factor, RpoS which regulates catalase I (katG) and catalase II (katE) instead of sigma 70 (σ70) factor (encoded by rpoD) (8). Activities of these enzymes are important

for resistance to hydrogen peroxide. To date, the transcriptional mechanism controlling the oxyR and rpoS genes in B. pseudomallei has not been extensively studied. The present Cell Cycle inhibitor study was conducted to clarify the roles of the two regulators, OxyR and RpoS (both of which affect katG expression), in adaptation to oxidative stress. The B. pseudomallei strains used are listed in Table 1. All strains were grown in the same growth rate pattern without significant differences and were routinely maintained in LB medium. All cultures were grown at 37°C with aeration induced by shaking at 250 rpm. Tetracycline (60 μg/ml), chloramphenicol (40 μg/ml), trimethoprim (100 μg/ml) and spectinomycin (100 μg/ml) were used as required. Chloramphenicol acetyltransferase (CAT, cat) and β-galactosidase (LacZ, Cyclin-dependent kinase 3 lacZ) were constructed as reporters for detection of the expression product. To produce strains with the desired genotypes, donor and recipient strains were inoculated in 3 ml LB medium and incubated overnight at 37°C with aeration. One percent of the overnight cultures was inoculated into 10 ml LB broth and grown to OD600= 0.4. An equal amount of donor and recipient strains were mixed in a ratio of 1:1 and washed twice with PBS buffer (120 mM NaCl, 16 mM Na2HPO4, 2H2O, 4 mM KH2PO4, pH 7.4). The mixture of bacterial cells was spotted on a piece of filter membrane, which had previously been placed on an LB agar plate. The plate was incubated overnight at 37°C with aeration.

© 2009 Wiley-Liss, Inc Microsurgery, 2010 “
“Recidivating

© 2009 Wiley-Liss, Inc. Microsurgery, 2010. “
“Recidivating pressure sores are a frequent complication in meningomyelocele patients because of their limitation in motility and their scarce ability

to monitor the pressure applied on insensate areas while seated. We report the utilization of the sensate pedicled anterolateral thigh perforator flap for reconstruction of ischiatic sores in meningomyelocele patients. Between May 2011 and September 2013, five patients underwent transfer of a sensate pedicled anterolateral thigh flap, by an intermuscular passageway through the upper thigh, to reach the ischial defect. Flap was properly harvested from the thigh after assessment of the lateral cutaneous femoral nerve sensitive area with the Pressure-Specified Sensory Device. In all cases the flap reached Proteasome inhibitor the ischial defect harmlessly, healing was uneventful with no immediate nor late complications. Each patient showed persistence of sensitivity at the reconstructed area and no recurrent ischiatic sore was observed at mean follow-up of 26.4 months. The sensate

pedicled anterolateral thigh flap is a valuable solution for coverage of recurrent ischial sores in meningomyelocele patients, in which pressure consciousness is fundamental. The intermuscular passageway allows to reduce the distance between flap’s vascular pedicle origin and the ischial defect, hence to use the more reliable skin from the middle third of the anterolateral thigh. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014. “
“Background: selleck inhibitor No consensus exists among microsurgeons regarding the role of intravenous (IV) heparin in digital replantation/revascularization. The current experience of the Provincial Replantation Center in Quebec was reviewed over a 4-year period. Methods:

An initial retrospective review of all revascularized or reimplanted digits at our Replantation Center from April 2004 to April 2006 was conducted. Then, data of all patients treated at our center from January 08 to September these 08 were prospectively collected. The two cohorts were compared with regards to demographics, injury characteristics, postoperative thromboprophylaxis medication as well as complication and success rates. Proportions were compared using χ2 tests/Fisher’s exact tests. Multivariate analysis was conducted with logistic regression. Results: 175 digits were treated from April 2004 to April 2006, including 104 revascularizations and 71 amputations. IV heparin was used in 35.1% of the cases and was associated with a 3.59-fold (95% CI, 1.55–8.31) increase risk of developing a complication compared with cases where heparin was not used (P = 0.001). In 2008, 106 digits were treated. IV heparin was used in 14.6% of the cases and was not significantly associated with a higher complication rate compared with cases where heparin was not used (P = 0.612). Both cohorts’ success rates were very similar (P = 0.557).

Understanding the role of primary cilia in the kidney continues t

Understanding the role of primary cilia in the kidney continues to provide clues concerning the pathogenesis of cystic kidney disease as well as epithelial homeostasis and regeneration. The near ubiquitous presence of primary cilia on epithelial cells in the kidney means that their involvement should be considered in a wide range of renal diseases and injuries. We

thank the Rotary Club of Wodonga and the Australian Chapter of the PKD foundation for supporting our studies of polycystic kidney disease. The micrographs in Figures 2 and 3 of this manuscript were obtained using instruments maintained by Monash MicroImaging. The Monash Institute of Medical Research is supported by the Victorian Government’s Operational Infrastructure Support Program. “
“Lupus Olaparib nephritis (LN) is a common and important manifestation of systemic lupus erythematosus (SLE). Evidence suggests higher rates of lupus renal involvement in Asian populations, and maybe more severe nephritis, compared with other racial or ethnic groups. The management of LN has evolved considerably over the past three decades, based on observations from clinical studies

that investigated different immunosuppressive agents including corticosteroids, cyclophosphamide, azathioprine, mycophenolic acid, calcineurin inhibitors and novel biologic therapies. This is accompanied by improvements in both the short-term treatment response Apitolisib concentration rate and long-term renal function preservation. Treatment guidelines for LN have recently been issued by rheumatology and nephrology communities in U.S.A. and Europe. In view of the racial difference in disease manifestation and response to therapy, for and the substantial disease burden in Asia, a panel of 15 nephrologists and rheumatologists from different Asian regions with extensive experience in

lupus nephritis – the Steering Group for the Asian Lupus Nephritis Network (ALNN) – met and discussed the management of lupus nephritis in Asian patients. The group has also reviewed and deliberated on the recently published recommendations from other parts of the world. This manuscript summarizes the discussions by the group and presents consensus views on the clinical management and treatment of adult Asian patients with LN, taking into account both the available evidence and expert opinion in areas where evidence remains to be sought. Systemic lupus erythematosus (SLE) is a potentially severe autoimmune disease that demonstrates variations in incidence, prevalence, disease activity and prognosis according to race and ethnicity.[1-3] Renal involvement affects over 60% of patients with SLE, and is a major contributor to morbidity and mortality.[4, 5] A systematic review of SLE in Asia has shown higher rates of renal involvement in Asian patients (21–65% at diagnosis and 40–82% at follow-up) compared with Caucasians.