Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
Kidney Int. 2019 May;95(5):1269-1272. doi: 10.1016/j.kint.2019.01.024. Epub 2019 Mar 1.
Fibrillary glomerulonephritis (FGN) is a rare glomerular disease. Kidney biopsy is required to establish the diagnosis. Recent studies have identified abundant glomerular deposition of DNAJB9 as a unique histological marker of FGN. We developed an immunoprecipitation-based multiple reaction monitoring method to measure serum levels of DNAJB9. We detected a 4-fold higher abundance of serum DNAJB9 in FGN patients when compared to controls, including patients with other glomerular diseases. Serum DNAJB9 levels were also negatively associated with estimated glomerular filtration rate in patients with FGN. Serum DNAJB9 levels accurately predicted FGN with moderate sensitivity (67%) and with high specificity (98%) and positive and negative predictive value (89% and 95%, respectively). A receiver operating curve analysis demonstrated an AUC of 0.958. These results suggest that serum levels of DNAJB9 could be a valuable marker to predict FGN, with the potential to complement kidney biopsy for the diagnosis of FGN.
纤维状肾小球肾炎 (FGN) 是一种罕见的肾小球疾病。需要进行肾脏活检以确立诊断。最近的研究发现，大量肾小球中 DNAJB9 的沉积是 FGN 的独特组织学标志物。我们开发了一种基于免疫沉淀的多重反应监测方法来测量血清 DNAJB9 水平。与对照组相比，包括患有其他肾小球疾病的患者在内，FGN 患者的血清 DNAJB9 含量高出 4 倍。在 FGN 患者中，血清 DNAJB9 水平与估计的肾小球滤过率呈负相关。血清 DNAJB9 水平对 FGN 的预测具有中等敏感性 (67%) 和高特异性 (98%)，阳性和阴性预测值分别为 89%和 95%。受试者工作特征曲线分析显示 AUC 为 0.958。这些结果表明，血清 DNAJB9 水平可能是预测 FGN 的一个有价值的标志物，具有补充肾脏活检以诊断 FGN 的潜力。
