Abstract
CD80, which regulates T cell activation, may provide a differential diagnostic marker between minimal change disease (MCD) and other renal diseases, including focal segmental glomerular sclerosis (FSGS). However, recent reports show contrasting results. Therefore, we evaluated the utility of urinary CD80 as a diagnostic biomarker. We collected 65 urine samples from 55 patients with MCD (n = 31), FSGS (n = 4), inherited nephrotic syndrome (n = 4), Alport syndrome (n = 5) and other glomerular diseases (n = 11), and control samples (n = 30). We measured urinary CD80 levels by ELISA. Urinary CD80 (ng/gCr) (median, interquartile range) levels were significantly higher in patients with MCD in relapse (91.5, 31.1–356.0), FSGS (376.2, 62.7–1916.0), and inherited nephrotic syndrome (220.1, 62.9–865.3), than in patients with MCD in remission (29.5, 21.7–52.8) (p < 0.05). Elevation of urinary CD80 was observed, even in patients with inherited nephrotic syndrome unrelated to T cell activation. Additionally, urinary CD80 was positively correlated with urinary protein levels. Our results suggest that urinary CD80 is unreliable as a differential diagnostic marker between MCD in relapse and FSGS or inherited kidney diseases. Increased urinary CD80 excretion was present in all patients with active kidney disease.
Highlights
CD80, which regulates T cell activation, may provide a differential diagnostic marker between minimal change disease (MCD) and other renal diseases, including focal segmental glomerular sclerosis (FSGS)
We evaluated the concentration of urinary CD80 of 65 samples from 55 patients with various renal diseases, including inherited diseases, to determine the utility of urinary CD80 as a diagnostic biomarker
Since Garin et al reported the utility of urinary CD80 as a differential biomarker between the relapse phase of MCD and other renal diseases in 200913, five other reports have been published concerning the use of this biomarker[12,18,20,21,22]
Summary
CD80, which regulates T cell activation, may provide a differential diagnostic marker between minimal change disease (MCD) and other renal diseases, including focal segmental glomerular sclerosis (FSGS). Urinary CD80 (ng/ gCr) (median, interquartile range) levels were significantly higher in patients with MCD in relapse (91.5, 31.1–356.0), FSGS (376.2, 62.7–1916.0), and inherited nephrotic syndrome (220.1, 62.9–865.3), than in patients with MCD in remission (29.5, 21.7–52.8) (p < 0.05). In inherited NS, variants of podocyte-related genes are linked, directly or indirectly, to specific defects of podocytes[5]; most patients with deleterious variants of these genes show significantly lower response to immunosuppressive therapy, or entirely lack a response to such therapy[6,7] This suggests that inherited NS is not associated with T-cell activation. Urinary CD80 was elevated in patients with MCD in relapse, but not in patients in remission or with FSGS13 From these results, it was hypothesized that the level of urinary CD80 was useful as a biomarker to distinguish between MCD patients in relapse and other renal diseases, including FSGS13
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