Anti-nephrin antibodies in adult Chinese patients with minimal change disease and primary focal segmental glomerulosclerosis
In 596 Chinese adults with biopsy-proven minimal change disease or primary FSGS, antinephrin antibodies were found in 43% and marked out patients with more severe nephrotic syndrome and more frequent relapses. The antibodies fell during remission and reappeared before relapse.
Background
Antinephrin autoantibodies have been described in minimal change disease and primary FSGS, particularly during active nephrotic syndrome, but prevalence and clinical significance in Asian adult populations were unknown.
Study design
596 adults with biopsy-proven disease (436 minimal change disease, 160 primary FSGS) were tested for antinephrin IgG and IgM by ELISA, with validation by antigen-inhibition ELISA and Western blotting; clinical data at biopsy and during follow-up were analysed longitudinally.
Key findings
Overall positivity was 43%, rising to 51.1% among patients with nephrotic-range proteinuria not receiving steroids or immunosuppressants. Clinical features were similar for IgG and IgM, but patients positive for both had the most severe proteinuria and the highest relapse frequency, suggesting a dose-dependent effect. Antibody levels fell significantly during clinical remission and reappeared ahead of proteinuric relapse.
Clinical implications
Serial antinephrin measurement may serve as a relapse-prediction biomarker and a candidate therapeutic target in adult podocytopathy, though the assay used here differs from the immunoprecipitation methods used in other cohorts.
Category
Research
Source
Kidney International
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