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Abstract: PO1844

Clinical Significance of Intensity of Galactose-Deficient IgA1 Deposition in Patients with IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Nakayama, Maiko, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Suzuki, Hitoshi, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Fukao, Yusuke, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Lee, Mingfeng, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Kano, Toshiki, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Makita, Yuko, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Suzuki, Yusuke, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
Background

Galactose-deficient IgA1 (Gd-IgA1) have a crucial role in the pathogenesis of IgA nephropathy (IgAN). It was reported that Gd-IgA1 specifically deposit on glomeruli of primary IgAN using Gd-IgA1-specific monoclonal antibody (KM55 mAb). However, the association between intensity of Gd-IgA1 deposition and histological severity and clinical parameters are not clear.

Methods

We performed immunostaining with anti-IgA and KM55 mAbs in 74 patients who were diagnosed as IgAN at Juntendo University Hospital. We quantified the intensity of glomerular Gd-IgA1 by Image J software, and analyzed its association with histological findings. We also analyzed the association of intensity of glomerular Gd-IgA1 with serum levels of Gd-IgA1 and creatinine, urinary Gd-IgA1 and proteinuria.

Results

Glomerular Gd-IgA1 was positive in all 74 primary IgAN cases, we divided into high-intensity (n=45) and low-intensity groups (n=29) by Image J software. In the Gd-IgA1 high-intensity group, acute lesions such as cellular crescents are dominant compared with low-intensity group (P=0.01). Moreover, the levels of proteinuria and urinary Gd-IgA1 were significantly high compared with Gd-IgA1 low-intensity group (P<0.05). Next, we analyzed the pathogenic significance of merge ratio of glomerular IgA and Gd-IgA1. Interestingly, levels of proteinuria and urinary Gd-IgA1 were correlated with high merge ratio of glomerular IgA and Gd-IgA1.

Conclusion

Present study suggested that high intensity of glomerular Gd-IgA1 deposition is associated with histological severity, especially acute lesions. Moreover, levels of proteinuria were correlated with high merge ratio of glomerular IgA and Gd-IgA1. Thus, glomerular Gd-IgA1 staining may be considerable index for therapeutic intervention.