ABSTRACT
A stepwise two-photon, red light excitation of organorhodium(III) phthalocyanine complexes was found to induce the activation of the axial metal-carbon bond to generate alkyl radicals/aldehydes. The cooperative action of the photouncaging reaction and the photochemical generation of reactive oxygen species were indicated to induce the cell deaths.
Subject(s)
Indoles , Light , Aldehydes , Carbon , Indoles/chemistry , Isoindoles , Reactive Oxygen Species/metabolismABSTRACT
RATIONALE: Anti-glomerular basement membrane (GBM) disease is a T cell-mediated disease that has a poor prognosis with conventional therapy. We tested rituximab as a primary therapy to reduce anti-GBM antibody produced by B cells. PATIENT CONCERNS: A 53-year old woman with complaints of a fever, headache and abdominal discomfort showed renal failure with elevated anti-GBM antibody, and renal biopsy revealed crescentic necrotizing glomerulonephritis with linear immunoglobulin G (IgG) 1 deposition along GBM. DIAGNOSES: The patient's plasma contained autoantibodies against Goodpasture antigen, which is the NC domain of collagen IVα3, and CD4-positive helper T cells were found surrounding crescent glomeruli with the coexistence CD20-positive B cells. INTERVENTIONS: Rituximab with steroid and plasma exchange. OUTCOMES: The levels of autoantibody for Goodpasture antigen were reduced, and the patient was able to temporarily withdraw from hemodialysis. LESSONS: B cell depletion with rituximab is effective as an initial therapy for anti-GBM disease.
