CD44-negative parietal-epithelial cell staining in minimal change disease : Association with clinical features, response to corticosteroids and kidney outcome
Roca, Neus (Universitat de Vic)
Jatem, Elias (Hospital Universitari Arnau de Vilanova)
Abo, Anabel (Institut de Recerca Biomèdica Dr Pifarré)
Santacana, Maria (Institut de Recerca Biomèdica Dr Pifarré)
Cruz, Alejandro (Hospital Universitari Vall d'Hebron)
Madrid, Álvaro (Hospital Sant Joan de Dèu Barcelona)
Fraga Rodríguez, Gloria María (Institut d'Investigació Biomèdica Sant Pau)
Martin, Marisa (Hospital Universitari Arnau de Vilanova)
Gonzalez, Jorge (Hospital Universitari Arnau de Vilanova)
Martinez, Cristina (Institut de Recerca Biomèdica Dr Pifarré)
Balius, Anna (Fundació Althaia de Manresa)
Segarra, Alfons (Hospital Universitari Arnau de Vilanova)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Activation of parietal-epithelial cells (PECs) with neo-expression of CD44 has been found to play a relevant role in the development of focal and segmental glomerulosclerosis (FSGS). The aim of this study was to analyse whether the expression of CD44 by PECs in biopsies of minimal change disease (MCD) is associated with the response to corticosteroids, with kidney outcomes and/or can be considered an early sign of FSGS. This multicentric, retrospective study included paediatric and adult patients with MCD. Demographic, clinical and biochemical data were recorded, and biopsies were stained with anti-CD44 antibodies. The association between PECs, CD44 expression and the response to corticosteroids, and kidney outcomes were analysed using logistic, Kaplan-Meier and Cox regression analyses. A total of 54 patients were included: 35 (65%) <18 years and 19 (35%) adults. Mean follow-up was 68. 3 ± 37. 9 months. A total of 19/54 patients (35. 2%) showed CD44-positive staining. CD44-positive patients were younger (14. 5 ± 5 versus 21. 5 ± 13, P = 0. 006), and showed a higher incidence of steroid-resistance [11/19 (57. 8%) versus 7/35 (20%), P = 0. 021; odds ratio: 5. 5 (95% confidence interval 1. 6-18), P = 0. 007] and chronic kidney disease [9/19 (47. 3%) versus 6/35 (17. 1%), P = 0. 021; relative risk: 3. 01 (95% confidence interval 1. 07-8. 5), P = 0. 037]. Follow-up re-biopsies of native kidneys (n = 18), identified FSGS lesions in 10/12 (83. 3%) of first-biopsy CD44-positive patients versus 1/6 (16. 7%) of first-biopsy CD44-negative patients (P = 0. 026). In patients with a light microscopy pattern of MCD, CD44-positive staining of PECs is associated with a higher prevalence of steroid resistance and worse kidney outcomes, and can be considered an early sign of FSGS.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	CD44 staining ; Focal and segmental glomerulosclerosis ; Idiopathic nephrotic syndrome ; Minimal change disease ; Parietal-epithelial cells
Published in:	Clinical Kidney Journal, Vol. 15 Núm. 3 (january 2022) , p. 545-552, ISSN 2048-8513

DOI: 10.1093/ckj/sfab215
PMID: 35211308

8 p, 1.5 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
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