Novelli Rubina, Gagliardini Elena, Ruggiero Barbara, Benigni Ariela, Remuzzi Giuseppe
IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro Anna Maria Astori, Science and Technology Park Kilometro Rosso, Bergamo, Italy;
IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro Anna Maria Astori, Science and Technology Park Kilometro Rosso, Bergamo, Italy; Unit of Nephrology and Dialysis, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy; and Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Am J Physiol Renal Physiol. 2016 Mar 1;310(5):F335-41. doi: 10.1152/ajprenal.00510.2015. Epub 2015 Dec 23.
Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are the most common causes of nephrotic syndrome in children and in young adults. Relapsing MCD carries the risk of severe complications and prolonged immunosuppression, whereas FSGS remains largely untreatable and urgently needs more effective treatments. Recently, induction of B7-1 (CD80), an immune-related protein expressed by antigen-presenting cells, was observed in podocytes of MCD and FSGS patients, suggesting that B7-1 plays a role in the pathogenesis of these diseases, and hence that abatacept, a B7-1 inhibitor, could be a possible treatment. Since previous studies raised serious concerns regarding the reliability of immunohistochemical assays for B7-1 detection and the efficacy of B7-1 inhibitory treatment, we investigated B7-1 podocyte expression in MCD and FSGS patients. Using different primary antibodies and immunohistochemical assays, no significant upregulation of podocyte B7-1 was detected in patients' biopsies compared with controls. To further confirm our findings, we analyzed mice with adriamycin-induced nephropathy, a model of human FSGS, and mice injected with LPS as additional control. Podocyte B7-1 was not observed in mice injected with adriamycin or LPS either. In conclusion, since B7-1 is not induced in podocyte of MCD and FSGS patients, the antiproteinuric action of abatacept, if confirmed, may not be the result of an effect on podocyte B7-1.
微小病变病(MCD)和局灶节段性肾小球硬化(FSGS)是儿童和青年肾病综合征最常见的病因。复发性MCD存在严重并发症和长期免疫抑制的风险,而FSGS在很大程度上仍无法治疗,迫切需要更有效的治疗方法。最近,在MCD和FSGS患者的足细胞中观察到抗原呈递细胞表达的免疫相关蛋白B7-1(CD80)的诱导,这表明B7-1在这些疾病的发病机制中起作用,因此B7-1抑制剂阿巴西普可能是一种可行的治疗方法。由于先前的研究对B7-1检测的免疫组织化学测定的可靠性以及B7-1抑制治疗的疗效提出了严重担忧,我们研究了MCD和FSGS患者中B7-1足细胞的表达。使用不同的一抗和免疫组织化学测定,与对照组相比,在患者活检中未检测到足细胞B7-1的显著上调。为了进一步证实我们的发现,我们分析了阿霉素诱导的肾病小鼠(一种人类FSGS模型)以及注射LPS作为额外对照的小鼠。在注射阿霉素或LPS的小鼠中也未观察到足细胞B7-1。总之,由于在MCD和FSGS患者的足细胞中未诱导B7-1,如果阿巴西普的抗蛋白尿作用得到证实,可能不是对足细胞B7-1产生影响的结果。