Bibliographic Details
| Title: |
Benefit of B7-1 staining and abatacept for treatment-resistant post-transplant focal segmental glomerulosclerosis in a predominantly pediatric cohort: time for a reappraisal. |
| Authors: |
Burke III, George W.1 gburke@med.miami.edu, Chandar, Jayanthi2, Sageshima, Junichiro3, Ortigosa-Goggins, Mariella4, Amarapurkar, Pooja5, Mitrofanova, Alla6, Defreitas, Marissa J.7, Katsoufis, Chryso P.7, Seeherunvong, Wacharee7, Centeno, Alexandra8, Pagan, Javier4, Mendez-Castaner, Lumen A.4, Mattiazzi, Adela D.4, Kupin, Warren L.4, Guerra, Giselle4, Chen, Linda J.1, Morsi, Mahmoud1, Figueiro, Jose M. G.1, Vianna, Rodrigo1,9, Abitbol, Carolyn L.7 |
| Source: |
Pediatric Nephrology. Jan2023, Vol. 38 Issue 1, p145-159. 15p. 2 Color Photographs, 1 Diagram, 2 Charts, 4 Graphs. |
| Subject Terms: |
*STAINS & staining (Microscopy), *BIOPSY, *NEPHROTIC syndrome, *KIDNEY transplantation, *PEDIATRICS, *PATIENTS, *SURGERY, *DISEASE relapse, *COMPARATIVE studies, *PROTEINURIA, *DESCRIPTIVE statistics, *EPITHELIAL cells, *FOCAL segmental glomerulosclerosis, *ABATACEPT, *LONGITUDINAL method, *TRANSPLANTATION of organs, tissues, etc. |
| Abstract: |
Background: Primary FSGS manifests with nephrotic syndrome and may recur following KT. Failure to respond to conventional therapy after recurrence results in poor outcomes. Evaluation of podocyte B7-1 expression and treatment with abatacept (a B7-1 antagonist) has shown promise but remains controversial. Methods: From 2012 to 2020, twelve patients developed post-KT FSGS with nephrotic range proteinuria, failed conventional therapy, and were treated with abatacept. Nine/twelve (< 21 years old) experienced recurrent FSGS; three adults developed de novo FSGS, occurring from immediately, up to 8 years after KT. KT biopsies were stained for B7-1. Results: Nine KTRs (75%) responded to abatacept. Seven of nine KTRs were B7-1 positive and responded with improvement/resolution of proteinuria. Two patients with rFSGS without biopsies resolved proteinuria after abatacept. Pre-treatment UPCR was 27.0 ± 20.4 (median 13, range 8–56); follow-up UPCR was 0.8 ± 1.3 (median 0.2, range 0.07–3.9, p < 0.004). Two patients who were B7-1 negative on multiple KT biopsies did not respond to abatacept and lost graft function. One patient developed proteinuria while receiving belatacept, stained B7-1 positive, but did not respond to abatacept. Conclusions: Podocyte B7-1 staining in biopsies of KTRs with post-transplant FSGS identifies a subset of patients who may benefit from abatacept. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR] |
|
Copyright of Pediatric Nephrology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Academic Search Complete |
|
Full text is not displayed to guests. |
Login for full access.
|
