Serological and histopathological assessment of galactose-deficient immunoglobulin A1 deposition in kidney allografts: A multicenter prospective observational study.

Sofue, Tadashi; Oguchi, Hideyo; Yazawa, Masahiko; Tsujita, Makoto; Futamura, Kenta; Nishihira, Morikuni; Toyoda, Mariko; Kano, Toshiki; Suzuki, Hitoshi

Sofue, Tadashi; Oguchi, Hideyo; Yazawa, Masahiko; Tsujita, Makoto; Futamura, Kenta; Nishihira, Morikuni; Toyoda, Mariko; Kano, Toshiki; Suzuki, Hitoshi.

Afiliación

Sofue T; Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan.
Oguchi H; Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan.
Yazawa M; Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Tsujita M; Department of Nephrology, Masuko Memorial Hospital, Nagoya, Japan.
Futamura K; Department of Kidney Disease Center, Japanese Red Cross Aichi Medical Center, Nagoya Daini Hospital, Aichi, Japan.
Nishihira M; Department of Kidney Disease Center, Japanese Red Cross Aichi Medical Center, Nagoya Daini Hospital, Aichi, Japan.
Toyoda M; Department of Nephrology, Yuuai Medical Center, Okinawa, Japan.
Kano T; Department of Nephrology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Suzuki H; Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan.

PLoS One ; 18(2): e0281945, 2023.

Article en En | MEDLINE | ID: mdl-36795799

RESUMEN

BACKGROUND: Recurrent immunoglobulin A (IgA) nephropathy is an important risk factor for kidney allograft loss. However, there is no classification system for IgA deposition in kidney allografts based on serological and histopathological evaluation of galactose-deficient IgA1 (Gd-IgA1). This study aimed to establish a classification system for IgA deposition in kidney allografts based on serological and histological evaluation of Gd-IgA1. METHODS: This multicenter prospective study included 106 adult kidney transplant recipients in whom an allograft biopsy was performed. Serum and urinary Gd-IgA1 levels were investigated in 46 transplant recipients who were IgA-positive and classified into four subgroups according to the presence or absence of mesangial Gd-IgA1 (KM55 antibody) deposits and C3. RESULTS: Minor histological changes without an acute lesion were observed in recipients with IgA deposition. Fourteen (30%) of the 46 IgA-positive recipients were KM55-positive and 18 (39%) were C3-positive. The C3 positivity rate was higher in the KM55-positive group. Serum and urinary Gd-IgA1 levels were significantly higher in KM55-positive/C3-positive recipients than in the other three groups with IgA deposition. Disappearance of IgA deposits was confirmed in 10 of 15 IgA-positive recipients in whom a further allograft biopsy was performed. The serum Gd-IgA1 level at the time of enrollment was significantly higher in recipients in whom IgA deposition continued than in those in whom it disappeared (p = 0.02). CONCLUSIONS: The population with IgA deposition after kidney transplantation is serologically and pathologically heterogeneous. Serological and histological assessment of Gd-IgA1 is useful for identifying cases that should be carefully observed.

Asunto(s)

Galactosa; Glomerulonefritis por IGA; Adulto; Humanos; Estudios Prospectivos; Inmunoglobulina A; Riñón/patología; Glomerulonefritis por IGA/patología; Aloinjertos/patología

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Galactosa / Glomerulonefritis por IGA Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos

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