The Evolving Role of Novel Biomarkers in Glomerular Disease: A Review

Abstract

Recent advances in glomerular biology have expanded our understanding of glomerular diseases, leading to more precise therapeutic options. Since the discovery of the autoantigen phospholipase A 2 receptor in primary membranous nephropathy 10 years ago, the serologic evaluation of glomerular diseases has become more detailed and nuanced for nephrologists. In addition to phospholipase A 2 receptor antibodies, circulating autoantibodies now include thrombospondin type 1 domain-containing 7A and most recently, neural epidermal growth factor-like 1 protein for membranous nephropathy. Additionally, discoveries in C3 glomerulopathy and fibrillary glomerulonephritis are poised to improve the diagnostic approach to these disorders by using novel biomarkers to complement traditional histologic patterns on kidney biopsy. Although kidney biopsies are considered the gold standard in profiling glomerular diseases, validated novel glomerular biomarkers contribute substantially to the diagnostic and therapeutic approaches through their ability to improve sensitivity, permit dynamic longitudinal monitoring of disease activity, and capture genetic heterogeneity. We describe the value of specific biomarkers in selected glomerular diseases, with the major focus on their clinical applicability. PLA 2 R MN Serology-Based Diagnosis of PLA 2 R MN Observational and retrospective studies have shown modest sensitivity but high specificity for serologic Complete author and article information provided before references.

Kynurenine pathway in kidney diseases

“…In many cases, the cause of glomerular damage cannot be established, and the pathogenic process is irreversible, despite the use of broad-spectrum immunosuppressive drugs. New glomerular targets may help improve diagnostic and therapeutic approaches, in conjunction with kidney biopsy and available serological markers, such as phospholipase A 2 receptor antibodies in membranous nephropathy [ 70 ]. Elevation of serum KYN levels in patients with glomerulonephritis and normal kidney function has been reported [ 71 ]; a high neopterin concentration was simultaneously observed, suggesting immunological system involvement in KYN pathway activation.…”

Exosomal proteomics in kidney disease: From technical approaches to clinical applications

“…Currently, the gold standard for diagnosing glomerulonephritis is kidney biopsy, which is invasive and inconvenient. Therefore, novel biomarkers would substantially improve the diagnosis and therapy of this disease [ 82 ]. Isolated microscopic hematuria is mostly due to Alport syndrome, immunoglobulin A nephropathy (IgAN), and thin basement membrane nephropathy (TBMN).…”

Pathogenetic and morphological features in certain types of primary glomerulonephritis

“…Обнаружена их корреляция с прогрессированием заболевания и рецидивом после трансплантации. Уровень Gd-IgA1 в сыворотке крови, как и наличие антигликановых антител, направленных против шарнирной области Gd-IgA1, представляют собой наиболее перспективные биомаркеры-кандидаты для оценки активности IgAН [21]. Также особый интерес представляет определение плазменной концентрации нового биомаркера -растворимой изоформы белка sST2 (soluble isoforms suppression of tumorigenicity 2), который производится клетками эндотелиальной ткани и относится к членам семейства рецепторов ИЛ-1.…”