P0354MATRIX ASSISTED LASER DESORPTION/IONIZATION MASS SPECTROMETRY IN PROTEIN ALTERATIONS ASSOCIATED WITH THE PROGRESSION OF IGA NEPHROPATHY DISCOVERY

Abstract

Abstract Background and Aims IgA nephropathy (IgAN) is one of the most diffuse glomerulonephrites worldwide, but there are still many issues regarding its prognosis and pathogenesis understanding. Although the diagnosis is established by renal biopsy examination, there are still remaining pitfalls in primary origin discrimination, and therefore for prognosis and outcome for the patient. Method In this pilot study we performed matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI) with a high spatial resolution (raster sampling of 20 μm) on formalin fixed paraffin embedded renal biopsies obtained from patients with IgAN (n=11) and other mesangioproliferative glomerulonephrites (MesPGN, n=6) attempting to enlighten proteomic alterations that may be associated with the progression of IgAN. The patients in both disease groups were separated according to their CKD stage (CKDI, CKDII, CKDIII and more). After MALDI-MSI analysis, all biopsies were stained with hematoxylin and eosin, scanned and overlaid with molecular image in order to verify the signals’ spatial distribution. Results Using MALDI-MSI we detected clear differences in the proteomic profiles of IgAN and other MesPGN tissues. Fourteen signals (AUC ≥ 0.8) were observed to have an altered intensity among the different CKD stages within the IgAN group. In particular, large increases in the intensity of these signals could be observed at CKD stages II and above. Putatively identified, these signals primarily corresponded to proteins involved in inflammatory and healing pathways and their increased intensity was localised within regions of tissue with large amounts of inflammatory cells or sclerosis (Figure 1), verified by immunohistochemical staining (Figure 2). Conclusion The capability of MALDI-MSI to provide highly spatially resolved proteomics analysis of complex renal tissue demonstrates it a useful additional diagnostic and prognostic tool and a promising approach in the search for prognostic or predictive markers in glomerular diseases.