Serum GDIgA1 levels in children with IgA nephropathy and Henoch-Schönlein nephritis

Abstract

IntroductionGDIgA1 (galactose deficient IgA1) plays a significant role in the pathogenesis of IgA nephropathy (IgAN) and Henoch-Schönlein nephritis (HSN).Aim of the studyThe aim of this study was to assess the relevance of serum GDIgA1 level as a prognostic marker in children with IgAN and HSN.Material and methods41 children were included to the study group (15 IgAN, 26 HSN) and 22 to the control group. The following parameters were evaluated at baseline and endpoint: proteinuria, erythrocyturia, serum creatinine, serum IgA, GFR. A kidney biopsy was performed in all patients and evaluated according to the Oxford Classification (1 – present, 0 – absent: M – mesangial hypercellularity; E– endocapillary hypercellularity; S – segmental sclerosis/adhesion; T – tubular atrophy/interstitial fibrosis), and was calculated as the total score (sum of M, E, S, T). At the end of follow-up, the serum GDIgA1 concentration was measured.ResultsThe serum GDIgA1 concentration in patients with IgAN and HSN was significantly higher than in the control group. No significant differences in mean proteinuria, erythrocyturia, GFR, MEST score, or GDIgA1 in serum, as well as the duration of follow-up between IgAN and HSN were observed. Baseline serum IgA concentration and time to kidney biopsy were significantly higher in children with IgAN than in children with HSN. We observed a positive correlation between GDIgA1 and IgA levels (r = 0.53), and GDIgA1 and serum creatinine levels (r = 0.5), as well as negative correlation between GDIgA1 and GFR (r = –0.37).ConclusionsSerum GDIgA1 level may have a prognostic value in children with IgAN and HSN; however, to fully elucidate its clinical potential further studies performed in larger patient cohorts are required.

A cross-sectional analysis of clinicopathologic similarities and differences between Henoch-Schönlein purpura nephritis and IgA nephropathy

“…With respect to a difference in Gd-IgA1 between the 2 diseases, our findings were consistent with previous reports [25,26,28]. Assessing Gd-IgA1 alone was not enough to distinguish between these 2 diseases.…”

“…In our recent report, serum Gd-IgA1 (s-Gd-IgA1) levels, quantified by a novel lectin-independent enzyme-linked immunosorbent assay (ELISA) using an anti-Gd-IgA1 monoclonal antibody (KM55) [27], were significantly elevated in patients with HSPN or IgAN compared to other kidney diseases [26]. Similar results were obtained in other recent studies [27,28]. Additionally, glomerular-Gd-IgA1 (g-Gd-IgA1)-deposition, assessed by immunofluorescence (IF) or immunohistochemistry (IHC) with KM55, was specific to patients with HSPN and IgAN [25,26].…”

Different histological classifications for Henoch-Schönlein purpura nephritis: which one should be used?

“… Other classifications Name of classification, authors, ref. Europe Koskela et al 2017 [ 30 ] Soylemezoglu et al 2009 [ 21 ] Lucas Garcia et al 2009 [ 47 ] Mizerska-Wasiak et al 2018 [ 41 ] Gülhan et al 2015 [ 42 ] Calvo-Río et al 2013 [ 43 ] Modified semiquantitative classification Koskela et al 2017 [ 30 ] Local pathological scoring Mohey et al 2013 [ 48 ] Pillebout et al 2002 [ 49 ] The classification developed by Heaton Altugan et al 2009 [ 50 ] Classification according to Emancipator Rauta et al 2002 [ 51 ] Coppo et al 1997 [ 13 ] North America Tarshish et al 2004 [ 31 ] N/A The classification adapted from Andreoli and Bergstein Foster et al 2000 [ 52 ] The classification developed by Heaton Heaton et al 1977 [ 53 ] Meadow’s classification Meadow et al 1972 [ 54 ] Latin America Buscatti et al 2018 [ 55 ] Fuentes et al 2014 [ 56 ] de Almeida et al 2007 [ 57 ] N/A N/A Asia Inagaki et al 2018 [ 44 ] Fu et al 2016 [ 58 ] Lim et al 2016 [ 25 ] Inagaki et al 2018 [ 44 ] Xu et al 2018 [ 17 ] Kim et al 2014 [ 35 ] Japanese histologic classification Inagaki et al 2018 [ 44 ] Scoring system described by Andreoli and Bergstein Kanai et al 2011 [ 59 ] Australia N/A …”

“…Findings from research on IgA nephropathy have been applied also to patients with HSPN. For instance, due to shared clinical, immunological and histological findings between the two diseases, it has been suggested that the Oxford classification can be used in classifying HSPN and it has been used in clinical practice [ 17 , 35 , 41 – 45 ]. Although these two diseases share similar features, there are also clinicopathological differences that are not only the mere presence of extrarenal clinical signs in IGAV/HSP [ 12 , 22 ].…”

Иммуноглобулин-А-Нефропатия У Детей: Обзор Литературы И Собственные Данные

“…Полученные нами данные позволяют предположить участие deGal-IgA1 в иммунопатогенезе IgAнефропатии у детей. Ряд исследователей в последние годы описывают общность патогенеза IgAN и IgA-васкулита ШГ, предполагая участие аберрантного IgA в развитии заболевания [31][32][33]. У пациентов с нефритом ШГ повышение уровня deGal-IgA1 отмечалось значимо чаще в сравнении со здоровыми детьми, но реже при сопоставлении с детьми с IgAN (р < 0,05).…”