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Coppo R, D'Arrigo G, Tripepi G, Russo ML, Roberts ISD, Bellur S, Cattran D, Cook TH, Feehally J, Tesar V, Maixnerova D, Peruzzi L, Amore A, Lundberg S, Di Palma AM, Gesualdo L, Emma F, Rollino C, Praga M, Biancone L, Pani A, Feriozzi S, Polci R, Barratt J, Del Vecchio L, Locatelli F, Pierucci A, Caliskan Y, Perkowska-Ptasinska A, Durlik M, Moggia E, Ballarin JC, Wetzels JFM, Goumenos D, Papasotiriou M, Galesic K, Toric L, Papagianni A, Stangou M, Benozzi L, Cusinato S, Berg U, Topaloglu R, Maggio M, Ots-Rosenberg M, D’Amico M, Geddes C, Balafa O, Quaglia M, Cravero R, Lino Cirami C, Fellstrom B, Floege J, Egido J, Mallamaci F, Zoccali C, Tesar V, Maixnerova D, Lundberg S, Gesualdo L, Emma F, Fuiano L, Beltrame G, Rollino C, Coppo R, Amore A, Camilla R, Peruzzi L, Praga M, Feriozzi S, Polci R, Segoloni G, Colla L, Pani A, Angioi A, Piras L, Feehally J, Cancarini G, Ravera S, Durlik M, Moggia E, Ballarin J, Di Giulio S, Pugliese F, Serriello I, Caliskan Y, Sever M, Kilicaslan I, Locatelli F, Del Vecchio L, Wetzels JFM, Peters H, Berg U, Carvalho F, da Costa Ferreira AC, Maggio M, Wiecek A, Ots-Rosenberg M, Magistroni R, Topaloglu R, Bilginer Y, D’Amico M, Stangou M, Giacchino F, Goumenos D, Papastirou M, Galesic K, Toric L, Geddes C, Siamopoulos K, Balafa O, Galliani M, Stratta P, Quaglia M, Bergia R, Cravero R, Salvadori M, Cirami L, Fellstrom B, Kloster Smerud H, Ferrario F, Stellato T, Egido J, Martin C, Floege J, Eitner F, Rauen T, Lupo A, Bernich P, Menè P, Morosetti M, van Kooten C, Rabelink T, Reinders MEJ, Boria Grinyo JM, Cusinato S, Benozzi L, Savoldi S, Licata C, Mizerska-Wasiak M, Roszkowska-Blaim M, Martina G, Messuerotti A, Dal Canton A, Esposito C, Migotto C, Triolo G, Mariano F, Pozzi C, Boero R, Mazzucco G, Giannakakis C, Honsova E, Sundelin B, Di Palma AM, Ferrario F, Gutiérrez E, Asunis AM, Barratt J, Tardanico R, Perkowska-Ptasinska A, Arce Terroba J, Fortunato M, Pantzaki A, Ozluk Y, Steenbergen E, Soderberg M, Riispere Z, Furci L, Orhan D, Kipgen D, Casartelli D, GalesicLjubanovic D, Gakiopoulou H, Bertoni E, Cannata Ortiz P, Karkoszka H, Groene HJ, Stoppacciaro A, Bajema I, Bruijn J, Fulladosa Oliveras X, Maldyk J, Ioachim E. Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update. Nephrol Dial Transplant 2018; 35:1002-1009. [DOI: 10.1093/ndt/gfy302] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 08/13/2018] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up.
Methods
In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1–10.8)].
Results
In this extended analysis, M1, S1 and T1–T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P < 0.01), and there was no effect modification by age for these associations, suggesting that they may be valid in children and in adults as well. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression. In separate prognostic analyses, the whole set of pathology lesions provided a gain in discrimination power over the clinical variables alone, which was similar at 5 years (+2.0%) and for the whole follow-up (+1.8%). A similar benefit was observed for risk reclassification analyses (+2.7% and +2.4%).
Conclusion
Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.
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Affiliation(s)
- Rosanna Coppo
- Fondazione Ricerca Molinette, Turin, Piemonte, Italy
| | | | | | | | | | - Shubha Bellur
- Cellular Pathology, Oxford University Hospital, Oxford, UK
| | | | | | - John Feehally
- Department of Nephrology, Leicester General Hospital, Leicester, UK
| | - Vladimir Tesar
- Nephrology, General University Hospital, Prague, Czech Republic
| | - Dita Maixnerova
- Nephrology, General University Hospital, Prague, Czech Republic
| | - Licia Peruzzi
- Nephrology, Regina Margherita Hospital, Turin, Italy
| | | | - Sigrid Lundberg
- Department of Nephrology, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Francesco Emma
- Department of Nephrology, Bambino Gesù Children’s Hospital – IRCCS, Rome, Italy
| | | | - Manuel Praga
- Department of Nephrology, H12Octubre, Madrid, Spain
| | | | | | | | - Rosaria Polci
- Department of Nephrology, Belcolle Hospital, Viterbo, Italy
| | - Jonathan Barratt
- Department of Nephrology, Leicester General Hospital, Leicester, UK
| | | | | | | | | | | | - Magdalena Durlik
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Jack F M Wetzels
- Department of Nephrology and Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dimitris Goumenos
- Department of Nephrology and Kidney Transplantation, University Hospital of Patras, Patras, Greece
| | - Marios Papasotiriou
- Department of Nephrology and Kidney Transplantation, University Hospital of Patras, Patras, Greece
| | | | - Luka Toric
- Department of Nephrology, Dubrava University, Zagreb, Croatia
| | - Aikaterini Papagianni
- Department of Nephrology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Stangou
- Department of Nephrology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Ulla Berg
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Huddinge, Sweden
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine Ankara, Turkey
| | - Milena Maggio
- Department of Nephrology, Hospital Maggiore di Lodi, Lodi, Italy
| | | | | | - Colin Geddes
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Olga Balafa
- Department of Nephrology, Medical School University of Ioannina, Ioannina, Greece
| | - Marco Quaglia
- Department of Nephrology, Maggiore della Carità Hospital, Piem, Onte Orientale University, Novara, Italy
| | | | | | | | - Jürgen Floege
- Division of Nephrology, Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Jesus Egido
- Department of Nephrology, Fundacion Jimenez Diaz, CIBERDEM, Madrid, Spain
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Barbour SJ, Espino-Hernandez G, Reich HN, Coppo R, Roberts IS, Feehally J, Herzenberg AM, Cattran DC, Bavbek N, Cook T, Troyanov S, Alpers C, Amore A, Barratt J, Berthoux F, Bonsib S, Bruijn J, D’Agati V, D’Amico G, Emancipator S, Emmal F, Ferrario F, Fervenza F, Florquin S, Fogo A, Geddes C, Groene H, Haas M, Hill P, Hogg R, Hsu S, Hunley T, Hladunewich M, Jennette C, Joh K, Julian B, Kawamura T, Lai F, Leung C, Li L, Li P, Liu Z, Massat A, Mackinnon B, Mezzano S, Schena F, Tomino Y, Walker P, Wang H, Weening J, Yoshikawa N, Zhang H, Coppo R, Troyanov S, Cattran D, Cook H, Feehally J, Roberts I, Tesar V, Maixnerova D, Lundberg S, Gesualdo L, Emma F, Fuiano L, Beltrame G, Rollino C, RC, Amore A, Camilla R, Peruzzi L, Praga M, Feriozzi S, Polci R, Segoloni G, Colla L, Pani A, Angioi A, Piras L, JF, Cancarini G, Ravera S, Durlik M, Moggia E, Ballarin J, Di Giulio S, Pugliese F, Serriello I, Caliskan Y, Sever M, Kilicaslan I, Locatelli F, Del Vecchio L, Wetzels J, Peters H, Berg U, Carvalho F, da Costa Ferreira A, Maggio M, Wiecek A, Ots-Rosenberg M, Magistroni R, Topaloglu R, Bilginer Y, D’Amico M, Stangou M, Giacchino F, Goumenos D, Kalliakmani P, Gerolymos M, Galesic K, Geddes C, Siamopoulos K, Balafa O, Galliani M, Stratta P, Quaglia M, Bergia R, Cravero R, Salvadori M, Cirami L, Fellstrom B, Kloster Smerud H, Ferrario F, Stellato T, Egido J, Martin C, Floege J, Eitner F, Lupo A, Bernich P, Menè P, Morosetti M, van Kooten C, Rabelink T, Reinders M, Boria Grinyo J, Cusinato S, Benozzi L, Savoldi S, Licata C, Mizerska-Wasiak M, Martina G, Messuerotti A, Dal Canton A, Esposito C, Migotto C, Triolo G, Mariano F, Pozzi C, Boero R, Bellur S, Mazzucco G, Giannakakis C, Honsova E, Sundelin B, Di Palma A, Ferrario F, Gutiérrez E, Asunis A, Barratt J, Tardanico R, Perkowska-Ptasinska A, Arce Terroba J, Fortunato M, Pantzaki A, Ozluk Y, Steenbergen E, Soderberg M, Riispere Z, Furci L, Orhan D, Kipgen D, Casartelli D, Galesic Ljubanovic D, Gakiopoulou H, Bertoni E, Cannata Ortiz P, Karkoszka H, Groene H, Stoppacciaro A, Bajema I, Bruijn J, Fulladosa Oliveras X, Maldyk J, Ioachim E. The MEST score provides earlier risk prediction in lgA nephropathy. Kidney Int 2016; 89:167-75. [DOI: 10.1038/ki.2015.322] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/17/2015] [Accepted: 09/03/2015] [Indexed: 01/12/2023]
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Esposito C, Migotto C, Torreggiani M, Maggi N, Manini A, Castoldi F, Grosjean F, Mangione F, Abelli M, Scaramuzzi M, Catucci D, Dal Canton A. Pretransplant and Protocol Biopsies May Help in Defining Short and Mid-term Kidney Transplant Outcome. Transplant Proc 2012; 44:1889-91. [DOI: 10.1016/j.transproceed.2012.07.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Esposito C, Abelli M, Sileno G, Migotto C, Torreggiani M, Serpieri N, Maggi N, Esposito V, Grosjean F, Scaramuzzi M, Montagna F, Canton A. Effects of Continuous Erythropoietin Receptor Activator (CERA) in Kidney Transplant Recipients. Transplant Proc 2012; 44:1916-7. [DOI: 10.1016/j.transproceed.2012.05.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kaynar K, Kaynar K, Ersoz S, Aliyazioglu R, Uzun A, Ulusoy S, Al S, Ozkan G, Cansiz M, Bertocchio JP, Lancon J, El Moghrabi S, Galmiche G, Duong Van Huyen JP, Rieu P, Jaisser F, Albertoni G, Andrade S, Barreto JA, Borges F, Schor N, Ho WY, Chen SH, Tseng CJ, Bienholz A, Feldkamp T, Weinberg JM, Suller Garcia J, Naves M, Borges F, Schor N, Borges F, Aparecida Reis L, Simoes MDJ, Schor N, S Almeida W, Moreau Longo V, Segreto HRC, Schor N, Ghoneim A, Elkholy A, Medhat Abbas T, El Hadeedy M, Elhusseini F, Elessawey B, Eltanaihy E, Lotfy A, Eldesoky S, Sheashaa H, Sobh M, Minning DM, Warnock D, Mohamed AS, Wirthlin JB, Chintalacharuvu SR, Boone L, Brenner RM, Borges F, Aparecida Reis L, Simoes MDJ, Schor N, Santina Christo J, Dos Santos Passos C, Aparecida Reis L, Rene de Alencar D, Suller Garcia J, Schor N, De Braganca AC, Canale D, Goncalves JG, Brandao TPB, Shimizu MHM, Volpini RA, Seguro AC, Andrade L, Canale D, De Braganca AC, Goncalves JG, Brandao TPB, Shimizu MHM, Volpini RA, Andrade L, Seguro AC, Lee JW, Kim HK, Cho WY, Jo SK, Cho E, Hocherl K, Schmidt C, Mulay SR, Kulkarni OP, Rupanagudi KV, Migliorini A, Liapis H, Anders HJ, Pevzner I, Chupyrkina A, Plotnikov E, Zorov D, Lopez-Novoa JM, Eleno N, Perez-Barriocanal F, Arevalo M, Docherty N, Castellano G, Divella C, Loverre A, Stasi A, Curci C, Rossini M, Ditonno P, Battaglia M, Daha MR, Van Kooten C, Gesualdo L, Schena FP, Grandaliano G, Tsuda H, Kawada N, Iwatani H, Moriyama T, Takahara S, Rakugi H, Isaka Y, Schley G, Kalucka J, Klanke B, Jantsch J, Olbrich S, Baumgartl J, Amann K, Eckardt KU, Weidemann A, Dolgolikova A, Pilotovich V, Ivanchik G, Shved I, Banki NF, Antal Z, Hosszu A, Koszegi S, Vannay A, Wagner L, Prokai A, Muller V, Szabo AJ, Fekete A, Farrag S, Abulasrar S, Salama ,M, Amin M, Ali A, Sheashaa H, Sobh M, Rubera I, Duranton C, Cougnon M, Melis N, Tauc M, Plotnikov E, Zorov D, Chupyrkina A, Jankauskas S, Morosanova M, Pevzner I, Pulkina N, Zorova L, Shin YT, Kim SS, Chang YK, Choi DE, Na KR, Lee KW, Choi JY, Jin DC, Cha JH, Schneider R, Betz B, Meusel M, Held C, Wanner C, Gekle M, Sauvant C, Pisani A, Rossano R, Mancini A, Arfian N, Yagi K, Nakayama K, Ali H, Mayasari DS, Purnomo E, Emoto N, Efrati S, Berman S, Abu Hamad R, Weissgarten J, Scherbaum CR, Allam R, Lichtnekert J, Darisipudi MN, Hagele H, Mulay SR, Rupanagudi KV, Hohenstein B, Hugo C, Schaefer L, Anders HJ, Corsi C, Ferramosca E, Grandi E, Pisoni L, Rivolta I, Dalpozzo B, Hoxha E, Severi S, Santoro A, Laurent M, Cedric R, Dominique C, Sophie V, Nochy D, Loic G, Patrice C, Chantal J, Marie-Christine V, Alexandre H, Eric R, Cantaluppi V, Medica D, Quercia AD, Figliolini F, Dellepiane S, Randone O, Segoloni GP, Camussi G, Shin YT, Choi DE, Na KR, Chang YK, Kim SS, Ahn BH, Kim SH, Lee KW, Yasue Saito Miyagi M, Camara N, Cerqueira Leite Seelaender M, Maceratesi Enjiu L, Estler Rocha Guilherme P, Pisciottano M, Hiyane M, Yuri Hayashida C, De Andrade Oliveira V, Olsen Saraiva Camara N, Tami Amano M, Sancho-Martinez SM, Sanchez-Juanes F, Vicente L, Gonzalez-Buitrago JM, Morales AI, Lopez-Novoa JM, Lopez-Hernandez FJ, Chen JS, Chang LC, Chen CC, Park MY, Choi SJ, Kim JG, Hwang SD, Vicente-Vicente L, Ferreira L, Prieto M, Garcia-Sanchez O, Sevilla MA, Lopez-Hernandez FJ, Lopez-Novoa JM, Morales AI, Vicente-Vicente L, Ferreira L, Gonzalez-Buitrago JM, Lopez-Novoa FJ, Lopez-Novoa JM, Morales AI, Christoph K, Kuper C, Maria-Luisa F, Franz-Xaver B, Neuhofer W, Vervaet B, Le Clef N, Verhulst A, D'haese P, Tanaka T, Yamaguchi J, Eto N, Kojima I, Fujita T, Nangaku M, Wystrychowski A, Wystrychowski G, Obuchowicz E, Grzeszczak W, Wiecek A, Esposito C, Torreggiani M, Castoldi F, Migotto C, Serpieri N, Grosjean F, Manini A, Pertile E, Dal Canton A. AKI - Experimental. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gerna G, Lilleri D, Chiesa A, Zelini P, Furione M, Comolli G, Pellegrini C, Sarchi E, Migotto C, Bonora MR, Meloni F, Arbustini E. Virologic and immunologic monitoring of cytomegalovirus to guide preemptive therapy in solid-organ transplantation. Am J Transplant 2011; 11:2463-71. [PMID: 21827612 DOI: 10.1111/j.1600-6143.2011.03636.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Control of human cytomegalovirus (HCMV) infection during the posttransplant period was investigated in 134 solid-organ transplant recipients by monitoring in parallel virologic and immunologic parameters for at least 1 year of follow-up. Virologic monitoring was achieved by determining HCMV DNAemia with real-time PCR, using the threshold of 300 000 DNA copies/mL blood as a cutoff for starting preemptive therapy. Immunologic monitoring included measurement of HCMV-specific CD4+ and CD8+ T cells by cytokine flow cytometry, using HCMV-infected dendritic cells as a stimulus. HCMV infection was diagnosed in 110 (82%) and required treatment in 49 (36%) patients. At 12 months after transplantation 'protective' immunity (≥0.4 CD4+ and CD8+ HCMV-specific T cells/μL blood) was achieved in 115/129 (89%) patients. During the entire study period, 122 patients reconstituting HCMV-specific CD4+ and CD8+ T-cell immunity at 60 days posttransplant onward were able to control HCMV infection, except for one patient who developed HCMV disease because of a rejection episode. Patients reconstituting HCMV-specific CD8+ only did not control HCMV infection. In conclusion, the presence of both HCMV-specific CD4+ and CD8+ T cells ≥ 0.4/μL blood appears to be protective against HCMV disease. This result does not apply to patients undergoing antirejection treatment, or reconstituting HCMV-specific CD8+ T cells only.
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Affiliation(s)
- G Gerna
- Laboratori Sperimentali di Ricerca, Area Trapiantologica, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy.
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Esposito C, Grosjean F, Torreggiani M, Maggi N, Esposito V, Migotto C, Mangione F, Tinelli C, Dal Canton A. Increased asymmetric dimethylarginine serum levels are associated with acute rejection in kidney transplant recipients. Transplant Proc 2009; 41:1570-3. [PMID: 19545681 DOI: 10.1016/j.transproceed.2009.03.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Revised: 03/01/2009] [Accepted: 03/11/2009] [Indexed: 11/19/2022]
Abstract
Asymmetric dimethylarginine (ADMA) has been identified as a marker of endothelial dysfunction and an independent risk factor for cardiovascular events in uremic subjects. This study evaluated ADMA plasma levels in kidney transplant recipients. ADMA levels were serially measured during the first year posttransplantation in 41 recipients treated with cyclosporine regimen (CY), sirolimus (SIR), or low-dose cyclosporine plus everolimus (E). Homocysteine, C reactive protein (CRP), nitric oxide (NO), and standard routine laboratory analyses were determined serially. ADMA significantly increased at 6 months posttransplantation, but was significantly lower among patients on SIR or E. NO was only slightly reduced in patients with increased ADMA levels. Interestingly, ADMA was significantly increased during the first 4 days posttransplantation in patients who experienced acute rejection during the first 6 months after transplantation. The same group of patients demonstrated higher levels of CRP and systolic blood pressure before transplantation. Our results demonstrated that ADMA was increased in patients on CY at 6 months. When increased soon after transplantation ADMA may be associated with episodes of acute rejection in kidney transplant recipients. The presence of elevated systolic blood pressure, as well as CRP and ADMA levels, suggested a role for endothelial dysfunction in the development of acute rejection episodes among deceased donor kidney transplant recipients.
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Affiliation(s)
- C Esposito
- Unit of Nephrology, Dialysis and Transplantation, Policlinico San Matteo, University of Pavia, Pavia, Italy.
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