Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis
Introduction: Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (GN) is characterized by pauci-immune crescentic GN. Myeloperoxidase ANCA-associated GN (MPO-ANCA GN) with membranous nephropathy (MN), where bright granular capillary MPO and IgG staining along the glomerular bas...
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Elsevier
2024-07-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924016760 |
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| author | Kenta Tominaga Etsuko Toda Kazuhiro Takeuchi Shoichiro Takakuma Emi Sakamoto Hideaki Kuno Yusuke Kajimoto Yasuhiro Terasaki Shinobu Kunugi Mika Terasaki Hiroyasu Goto Toshihiko Imakiire Naoki Oshima Akira Shimizu |
| author_facet | Kenta Tominaga Etsuko Toda Kazuhiro Takeuchi Shoichiro Takakuma Emi Sakamoto Hideaki Kuno Yusuke Kajimoto Yasuhiro Terasaki Shinobu Kunugi Mika Terasaki Hiroyasu Goto Toshihiko Imakiire Naoki Oshima Akira Shimizu |
| author_sort | Kenta Tominaga |
| collection | DOAJ |
| description | Introduction: Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (GN) is characterized by pauci-immune crescentic GN. Myeloperoxidase ANCA-associated GN (MPO-ANCA GN) with membranous nephropathy (MN), where bright granular capillary MPO and IgG staining along the glomerular basement membrane (GBM) is present, has been reported; however, its clinicopathological features remain unclear. Methods: We investigated 7 MPO-ANCA GN with MN and 11 control cases (6 MPO-ANCA GN and 5 primary MN cases). Proteomics of laser microdissected glomeruli followed by immunohistochemical analysis was performed to identify causal antigens in MPO-ANCA GN with MN. We described the clinicopathological features of MPO-associated MN compared with those of MPO-ANCA GN and primary MN. Results: We detected proteomic MPO and granular capillary MPO deposits in all MPO-ANCA GN with MN cases. Confocal microscopy revealed MPO and IgG colocalization along the GBM. MPO-associated MN clinicopathological features include greater proteinuria, a higher fibrous crescent rate, and a lower MPO-ANCA titer than MPO-ANCA GN. The estimated glomerular filtration rate (eGFR) and urinary protein excretion were lower in MPO-associated MN than in primary MN. Conclusion: MPO-associated MN, a unique type of secondary MN where MPO serves as the causal antigen, is a subset of MPO-ANCA GN with MN. Prolonged periods of MPO-ANCA GN and a low MPO-ANCA titer might be related to MPO-associated MN development. |
| format | Article |
| id | doaj-art-7b02c915008444d8a6bd1672c3fdeae3 |
| institution | DOAJ |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-7b02c915008444d8a6bd1672c3fdeae32025-08-20T03:21:11ZengElsevierKidney International Reports2468-02492024-07-01972240224910.1016/j.ekir.2024.04.041Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated GlomerulonephritisKenta Tominaga0Etsuko Toda1Kazuhiro Takeuchi2Shoichiro Takakuma3Emi Sakamoto4Hideaki Kuno5Yusuke Kajimoto6Yasuhiro Terasaki7Shinobu Kunugi8Mika Terasaki9Hiroyasu Goto10Toshihiko Imakiire11Naoki Oshima12Akira Shimizu13Department of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDivision of Nephrology and Hypertension, The Jikei University School of Medicine, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan; Division of Pathology, Nippon Medical School Hospital, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, JapanDepartment of Nephrology and Endocrinology, National Defense Medical College, Saitama, JapanDepartment of Nephrology and Endocrinology, National Defense Medical College, Saitama, JapanDepartment of Nephrology and Endocrinology, National Defense Medical College, Saitama, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan; Correspondence: Akira Shimizu, Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan.Introduction: Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (GN) is characterized by pauci-immune crescentic GN. Myeloperoxidase ANCA-associated GN (MPO-ANCA GN) with membranous nephropathy (MN), where bright granular capillary MPO and IgG staining along the glomerular basement membrane (GBM) is present, has been reported; however, its clinicopathological features remain unclear. Methods: We investigated 7 MPO-ANCA GN with MN and 11 control cases (6 MPO-ANCA GN and 5 primary MN cases). Proteomics of laser microdissected glomeruli followed by immunohistochemical analysis was performed to identify causal antigens in MPO-ANCA GN with MN. We described the clinicopathological features of MPO-associated MN compared with those of MPO-ANCA GN and primary MN. Results: We detected proteomic MPO and granular capillary MPO deposits in all MPO-ANCA GN with MN cases. Confocal microscopy revealed MPO and IgG colocalization along the GBM. MPO-associated MN clinicopathological features include greater proteinuria, a higher fibrous crescent rate, and a lower MPO-ANCA titer than MPO-ANCA GN. The estimated glomerular filtration rate (eGFR) and urinary protein excretion were lower in MPO-associated MN than in primary MN. Conclusion: MPO-associated MN, a unique type of secondary MN where MPO serves as the causal antigen, is a subset of MPO-ANCA GN with MN. Prolonged periods of MPO-ANCA GN and a low MPO-ANCA titer might be related to MPO-associated MN development.http://www.sciencedirect.com/science/article/pii/S2468024924016760antigenantineutrophil cytoplasmic antibodyglomerular basement membraneglomerulonephritismembranous nephropathymyeloperoxidase |
| spellingShingle | Kenta Tominaga Etsuko Toda Kazuhiro Takeuchi Shoichiro Takakuma Emi Sakamoto Hideaki Kuno Yusuke Kajimoto Yasuhiro Terasaki Shinobu Kunugi Mika Terasaki Hiroyasu Goto Toshihiko Imakiire Naoki Oshima Akira Shimizu Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis Kidney International Reports antigen antineutrophil cytoplasmic antibody glomerular basement membrane glomerulonephritis membranous nephropathy myeloperoxidase |
| title | Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis |
| title_full | Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis |
| title_fullStr | Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis |
| title_full_unstemmed | Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis |
| title_short | Myeloperoxidase-Associated Membranous Nephropathy in Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis |
| title_sort | myeloperoxidase associated membranous nephropathy in antineutrophil cytoplasmic antibody associated glomerulonephritis |
| topic | antigen antineutrophil cytoplasmic antibody glomerular basement membrane glomerulonephritis membranous nephropathy myeloperoxidase |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924016760 |
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