Abstract: PO1586
Intensity of Glomerular Galactose-Deficient IgA1 Deposition Can Be a Marker of Disease Activity in IgA Nephropathy
Session Information
- Glomerular Diseases: Clinicopathological Features and Outcomes in IgAN, Lupus Nephritis, and Vasculitis
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
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 Nerima Hospital, 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) plays a crucial role in the development of IgA nephropathy (IgAN). Recently, 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 the intensity of Gd-IgA1 deposition and clinical parameters and histological severity are not clarified.
Methods
We performed immunostaining with KM55 mAb on paraffin sections of 141 patients diagnosed with 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 deposition with creatinine, serum/urinary level of Gd-IgA1, and proteinuria.
Results
In all 141 patients with primary IgAN, glomerular Gd-IgA1 deposition was positive. We divided patients into tertiles according to the amount of Gd-IgA1 deposition by the Image-J software (low, middle, and high groups). The level of proteinuria in the high-intensity group was significantly higher than that in the other two groups (low vs high; P<0.05, middle vs high; P<0.05). Moreover, the level of urinary Gd-IgA1 was also higher in the high-intensity group (middle vs high; P<0.05). The percentage of acute lesions such as cellular crescents was significantly higher in the high-intensity group (low vs high; P<0.05).
Conclusion
Present study suggested that high intensity of glomerular Gd-IgA1 deposition is associated with histological severity, especially acute lesions. Thus, glomerular Gd-IgA1 staining can be considerable index for therapeutic intervention.