ABSTRACT
Avacopan, a C5a receptor antagonist (C5aR) presents a new therapeutic option to improve outcomes in ANCA-associated vasculitis (AAV). Here we present a case report of a patient initially requiring kidney replacement therapy (KRT), where avacopan was added as an additional adjunctive therapeutic agent late in the treatment course.
Subject(s)
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis , Granulomatosis with Polyangiitis , Nipecotic Acids , Humans , Granulomatosis with Polyangiitis/drug therapy , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy , Kidney , Aniline Compounds/therapeutic use , Antibodies, Antineutrophil CytoplasmicABSTRACT
A new anisotropic soft material - a liquid crystal 'hydroglass' (LCH) - is created from aqueous suspensions of nanocrystalline cellulose (NCC) colloidal rods. Under specific conditions, the NCC suspension separates into a colloid-rich attractive glass matrix phase and a coexisting liquid crystal phase. LCH provides similar viscoelastic properties to polymer and colloidal gels, but permits reversibly-orientating the colloidal rods through shear forces.
ABSTRACT
The colloidal size and rod morphology of nanocrystalline cellulose (NCC) lead to suspensions with useful phase and gelation behaviours as well as complex rheologies. However, these have not been comprehensively evaluated previously. Here we report the detailed phase behaviour of sulphonated NCC aqueous suspensions as a function of concentration and salinity. Four phases - liquid, viscoelastic, repulsive glass and attractive glass/gel - are identified in terms of their distinct rheological behaviours. The liquid-solid transitions (LSTs) are determined rheologically, and these are supported by a simplified model based on the DLVO theory that indicates the importance of charge in determining the phase behaviour. Rheology is also used to investigate the solid-solid transition from a repulsive glass to an attractive gel with increasing salt at high NCC concentrations. A time-dependent aging phenomenon is observed in suspensions with a composition just below the LSTs, and the implications of this on the dynamics occurring during gelation processes are discussed. This work can be directly applied to the development of structure-function relationships and the expanding utilisation of NCC suspensions, whilst also providing a basis for the study of charged colloidal rods more generally and evaluation of theoretical models.
ABSTRACT
HYPOTHESIS: Nanocrystalline cellulose (NCC) is a negatively charged rod-like colloid obtained from the hydrolysis of plant material. It is thus expected that NCC suspensions display a rich set of phase behaviour with salt and pH because of its anisotropic shape and electrical double layer that gives rise to liquid crystallinity and self-assembly respectively. It should thus be possible to tune the rheological properties of NCC suspensions for a wide variety of end-use applications. EXPERIMENTS: Rheology and structural analysis techniques are used to characterise surface-sulphated NCC suspensions as a function of pH, salinity (NaCl) and NCC concentration. Structural techniques include atomic force microscopy, Zeta potential, dynamic light scattering, and scanning electron microscopy. FINDINGS: A phase diagram is developed based on the structure-rheology measurements showing various states of NCC that form as a function of salt and NCC concentration, which go well beyond those previously reported. This extended range of conditions reveals regions where the suspension is a viscous fluid and viscoelastic soft solid, as well as regions of instability that is suggested to arise when there is sufficient salt to reduce the electrical double layer (as explained qualitatively using DLVO theory) but insufficient NCC to form a load bearing network.
