Abstract
B7-1 is thought to play a pathogenic role in minimal-change disease (MCD). Recently, however, doubts have arisen regarding the role of B7-1 expression in MCD. Therefore, we aimed to identify the presence and clinical significance of B7-1 expression in MCD patients. The study participants included 28 adult MCD patients for whom kidney specimens were available. The intensity of B7-1 expression was assessed by two independent specialists. We analysed the association between the intensity of B7-1 expression and clinicopathological variables. No B7-1 expression in the glomeruli was observed in any of the 28 patients. Unexpectedly, however, 75.0% of the patients exhibited tubular B7-1 expression, with 35.7% demonstrating weak positive expressions and 39.3% demonstrating strong positive expressions. The level of proteinuria significantly increased as the intensity of tubular B7-1 expression increased. We also found trends of increasing blood urea nitrogen and serum creatinine levels with increased intensity of tubular B7-1 expression. However, we could not observe definite differences in long- and short-term clinical outcomes depending on the intensity of tubular B7-1 expression. In conclusion, B7-1 was expressed in renal tubular cells but not in glomeruli in adult MCD patients. The intensity of tubular B7-1 expression paralleled proteinuria levels, but not clinical outcomes.
Highlights
B7-1 is thought to play a pathogenic role in minimal-change disease (MCD)
Since Reiser et al reported an unanticipated role of B7-1 in podocytes as an inducible modifier of glomerular permeability in proteinuric diseases[12], several studies have been performed to examine the clinical significance of B7-1 expression in patients with MCD13–17
B7-1 expression has been suggested to play a key role in proteinuric renal disease by increasing glomerular permeability[12], and the activity of B7-1 could be suppressed by CTLA-4 fusion proteins such as abatacept[18]
Summary
B7-1 is thought to play a pathogenic role in minimal-change disease (MCD). Recently, doubts have arisen regarding the role of B7-1 expression in MCD. The level of proteinuria significantly increased as the intensity of tubular B7-1 expression increased. B7-1 was expressed in renal tubular cells but not in glomeruli in adult MCD patients. The intensity of tubular B7-1 expression paralleled proteinuria levels, but not clinical outcomes. Since Reiser et al reported an unanticipated role of B7-1 in podocytes as an inducible modifier of glomerular permeability in proteinuric diseases[12], several studies have been performed to examine the clinical significance of B7-1 expression in patients with MCD13–17. B7-1 expression might be induced in the glomeruli and in the tubules[22,23,24] To elucidate these uncertainties, we performed the present study in adult patients with biopsy-proven MCD
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