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Abstract: SA-PO991

FSGS Recurrence Modeling Using Induced Pluripotent Stem Cell (iPSC)-Derived Podocytes in Patients with Idiopathic Nephrotic Syndrome

Session Information

Category: Glomerular Diseases

  • 1403 Podocyte Biology

Authors

  • van den Berge, Bartholomeus Tideman, RadboudUMC department of Nephrology, Nijmegen, Netherlands
  • Jansen, Jitske, RWTH Aachen Institute of Experimental Medicine and Systems Biology, Aachen, Germany
  • Wetzels, Jack F., RadboudUMC department of Nephrology, Nijmegen, Netherlands
  • Smeets, Bart, RadboudUMC department of Pathology, Nijmegen, Netherlands
  • Maas, Rutger J., RadboudUMC department of Nephrology, Nijmegen, Netherlands
Background

Clinical outcome is highly variable, often resulting in renal failure, in patients with idiopathic Nephrotic syndrome and disease returns after transplantation (Tx) in about 50% of patients. Proposed circulating permeability factors (CPFs) are as of yet few and unvalidated in larger cohorts. In vitro assays to detect podocyte damage result in heterogeneous outcomes. Taken together, there are potential patient- and donor-specific characteristics that influence disease outcome after Tx. Here, we modelled FSGS recurrence using iPSC-derived podocytes.

Methods

We included 5 patient-donor couples with known outcomes of FSGS recurrence after Tx (3x recurrence, 2x non-recurrence) and generated iPSCs out of PBMCs. We subsequently exposed iPSC-derived podocytes to suspected CPF-containing plasmas and measured podocyte damage using various previously published in vitro damage assays.

Results

Using an optimized hybrid directed differentiation protocol, we successfully created iPSC-derived podocytes showing podocytes-specific markers. We were able to model primary FSGS using patients’ iPSC-derived podocytes exposed to pre-Tx plasma (patient-specifically) mimicking the in vivo situation. We also modelled FSGS recurrence using donor iPSC-derived podocytes exposed to post-Tx plasma (patient-specifically)(Figure 1) again according to the in vivo situation. Differences in damage response between iPSC-derived podocyte cellines suggest we found proof for donor-specific characteristics that may influence disease recurrence after Tx using a crossmatching experiment.

Conclusion

iPSC-derived podocytes can be used to model primary FSGS and FSGS recurrence. Data suggests that currently unknown donor-specific characteristics may influence disease outcome after Tx in patients with idiopathic Nephrotic syndrome. We aim to further study these potential donor-specific characteristics.

Funding

  • Government Support – Non-U.S.