Journal Article

Correlation of Serum Galactose-Deficient IgA1 and Oxford Class in Cases of IgA Nephropathy

Rao, Namrata Sarvepalli, Malhotra, Kiran Preet, Shukla, Monika, Chandra, Abhilash, Ahmad, Mohammad Kaleem

2024

Overview

Galactose-deficient immunoglobulin A1 (Gd-IgA1) deposition in the renal mesangium plays a role in the pathogenesis of IgA nephropathy. To assess the serum Gd-IgA1 level in biopsy-proven IgA nephropathy cases at diagnosis and 3 months post treatment and its relation with histologic Oxford classification. In this hospital-based prospective cohort study, 40 cases and 20 controls were enrolled. Serum samples of biopsy-proven IgA nephropathy cases collected on the day of biopsy and 3 months post treatment were evaluated. Solid-phase ELISA (enzyme-linked immunosorbent assay) was performed for assessment of Gd-IgA1 level. All renal biopsies were scored by using the Oxford classification (C-MEST score). The association of serum Gd-IgA1 levels with other established prognostic parameters was assessed. To estimate the prognostic value of markers, logistic regression analysis and Kruskal-Wallis ANOVA (analysis of variance) were used. A significant difference was observed in the serum Gd-IgA1 level values in the IgA nephropathy cases and healthy controls (P = .001) at baseline. However, no significant correlation between serum Gd-IgA1 levels at baseline and 3 months of follow-up (P = .31) or between baseline levels and age, proteinuria, hematuria, or estimated glomerular filtration rate was noted. There was no significant correlation between C-MEST score and serum Gd-IgA1 levels at baseline (P > .05); however, the distribution of Gd-IgA1 at 3 months was found to differ significantly between different grades of S score (P = .008). Serum Gd-IgA1 levels may be of utility in predicting disease progression in IgA nephropathy cases. Measurement of serum Gd-IgA1 levels for the diagnosis and prognosis of IgA nephropathy may preclude the need for invasive renal biopsies.

• Publisher: College of American Pathologists
• Subject: Adult / Analysis / Antigen-antibody complexes / Autoantibodies / Biomarkers / Biomarkers - blood / Biopsy / Case-Control Studies / Classification / Cohort analysis / D-Galactosamine / Diabetes / Diagnosis / Edema / Enzyme-Linked Immunosorbent Assay / Enzymes / Female / Galactose / Galactose - blood / Galactose - deficiency / Glomerulonephritis, IGA - blood / Glomerulonephritis, IGA - diagnosis / Glomerulonephritis, IGA - pathology / Glycosylation / Health aspects / Hematuria / Humans / Hypertension / IgA glomerulonephritis / IgA nephropathy / Immunoglobulin A / Immunoglobulin A - blood / Immunoglobulins / Kidney - pathology / Kidney diseases / Male / Medical research / Medicine, Experimental / Microscopy / Middle Aged / N-Acetylgalactosamine / Nephritis / Oliguria / Pathogenesis / Patients / Physiological aspects / Polysaccharides / Prognosis / Prospective Studies / Proteins / Regression analysis / Remission (Medicine) / Sample size / Urine / Variance analysis / Young Adult