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Abstract: PO1586

Intensity of Glomerular Galactose-Deficient IgA1 Deposition Can Be a Marker of Disease Activity in 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 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.