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3. Clinical-Pathological Characteristics of Renal Injuries Identify Different Clusters in Patients With Antiphospholipid Antibodies

Author

Sciascia, Savino, Yazdany, Jinoos, Moroni, Gabriella, Becker, Jan Ulrich, Seshan, Surya V, Andrade, Danieli, Emmi, Giacomo, Cuadrado, Maria J, Radin, Massimo, Cecchi, Irene, De Simone, Emanuele, Barreca, Antonella, Caroti, Leonardo, Innocenti, Samantha, Fenoglio, Roberta, and Roccatello, Dario

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Kidney Disease, Hematology, Rare Diseases, Lupus, Autoimmune Disease, Clinical Research, Inflammatory and immune system, antiphospholipid antibodies, antiphospholipid syndrome, APS nephropathy, systemic lupus erythema-tosus, thrombosis, thrombotic microangiopathy, systemic lupus erythematosus, Biomedical and clinical sciences, Health sciences
Abstract

IntroductionSignificant heterogeneity still exists in the nomenclature of renal involvement in antiphospholipid syndrome (APS).MethodsWe applied a hierarchical cluster analysis to determine subgroups of patients according to clinical, laboratory, and renal histology characteristics in a cohort of subjects with confirmed antiphospholipid antibodies (aPL) positivity and biopsy proven aPL-related renal injuries. Kidney outcomes were then assessed at 12 months.ResultsA total of 123 aPL-positive patients were included in the study (101 [82%] female, 109 [88.6%] with systemic lupus erythematosus [SLE], 14 (11.4%) with primary APS [PAPS]). Three clusters were identified. Twenty-three patients (18.7%) were included in the first cluster (cluster 1), characterized by a higher prevalence of glomerular capillary and arteriolar thrombi and fragmented red blood cells in the subendothelial space. Cluster 2 included 33 patients (26.8%) and showed a higher prevalence of fibromyointimal proliferative lesions as seen in hyperplastic vasculopathy. Cluster 3 was the largest (67 patients, mainly with SLE) and was characterized by higher prevalence of subendothelial edema, of both glomerular capillaries and arterioles.ConclusionThree different clusters of patients with aPL and renal injuries emerged from our study as follows: the first, with the worst renal prognosis, was associated with features of thrombotic microangiopathy (TMA), thrombosis, triple aPL positivity and higher adjusted Global APS Score (aGAPSS) values; the second, characterized by hyperplastic vasculopathy with an intermediate prognosis, was seen more frequently in patients with cerebrovascular manifestations; and the third, more benign in terms of outcomes and with no overt association with thrombotic features, was characterized by endothelial swelling in concomitant lupus nephritis (LN).

Published
2023

4. Cryoglobulinemia and Emerging Related Disorders

Author

Roccatello, Dario, Barreca, Antonella, Sciascia, Savino, Fenoglio, Roberta, De Simone, Emanuele, Moniaci, Diego, Sethi, Sanjeev, Emmi, Lorenzo, Series Editor, Prisco, Domenico, Series Editor, Salvarani, Carlo, Editorial Board Member, Sinico, Renato Alberto, Editorial Board Member, Meroni, Pier Luigi, Editorial Board Member, Roccatello, Dario, Editorial Board Member, Matucci-Cerinic, Marco, Editorial Board Member, Gattorno, Marco, Editorial Board Member, de Benedetti, Fabrizio, Editorial Board Member, Cimaz, Rolando, Editorial Board Member, Plebani, Alessandro, Editorial Board Member, Baldari, Cosima Tatiana, Editorial Board Member, D'Elios, Mario Milco, Editorial Board Member, and Vaglio, Augusto, Editorial Board Member

Published
2024
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5. Nephrological and Rheumatic Complications of Checkpoint Inhibitors

Author

Roberta, Fenoglio, Roccatello, Dario, Barreca, Antonella, De Simone, Emanuele, Savino, Sciascia, Emmi, Lorenzo, Series Editor, Prisco, Domenico, Series Editor, Salvarani, Carlo, Editorial Board Member, Sinico, Renato Alberto, Editorial Board Member, Meroni, Pier Luigi, Editorial Board Member, Roccatello, Dario, Editorial Board Member, Matucci-Cerinic, Marco, Editorial Board Member, Gattorno, Marco, Editorial Board Member, de Benedetti, Fabrizio, Editorial Board Member, Cimaz, Rolando, Editorial Board Member, Plebani, Alessandro, Editorial Board Member, Baldari, Cosima Tatiana, Editorial Board Member, D'Elios, Mario Milco, Editorial Board Member, and Vaglio, Augusto, Editorial Board Member

Published
2024
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6. Application of the updated International IgA Nephropathy Prediction Tool in children one or two years post-biopsy

Author

Zeng, Caihong, Su, Biage, Zhong, Xuhui, Nakanishi, Koichi, Zhai, Yihui, Urushihara, Maki, Hattori, Motoshi, Camassei, Francesca Diomedi, Barreca, Antonella, Robert, Thomas, Prikhodina, Larisa, Berg, Ulla, Topaloglu, Rezan, Mizerska-Wasiak, Malgorzata, Papagianni, Aikaterini, Bellur, Shubha S., Roberts, Ian, Barbour, Sean J., Coppo, Rosanna, Er, Lee, Russo, Maria Luisa, Liu, Zhi-Hong, Ding, Jie, Katafuchi, Ritsuko, Yoshikawa, Norishige, Xu, Hong, Kagami, Shoji, Yuzawa, Yukio, Emma, Francesco, Cambier, Alexandra, Peruzzi, Licia, Wyatt, Robert J., and Cattran, Daniel C.

Published
2024
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8. Histologic and Clinical Factors Associated with Kidney Outcomes in IgA Vasculitis Nephritis

Author

Barbour, Sean J., Coppo, Rosanna, Er, Lee, Pillebout, Evangeline, Russo, Maria Luisa, Alpers, Charles E., Fogo, Agnes B., Ferrario, Franco, Jennette, J. Charles, Roberts, Ian S.D., Cook, H. Terence, Ding, Jie, Su, Baige, Zhong, Xuhui, Fervenza, Fernando C., Zand, Ladan, Peruzzi, Licia, Lucchetti, Laura, Katafuchi, Ritsuko, Shima, Yuko, Yoshikawa, Norishige, Ichikawa, Daisuke, Suzuki, Yusuke, Murer, Luisa, Wyatt, Robert J., Park, Catherine, Nelson, Raoul D., Narus, JoAnn H., Wenderfer, Scott, Geetha, Duvuru, Daugas, Eric, Monteiro, Renato C., Nakatani, Shinya, Mastrangelo, Antonio, Nuutinen, Matti, Koskela, Mikael, Weber, Lutz T., Hackl, Agnes, Pohl, Martin, Pecoraro, Carmine, Tsuboi, Nobuo, Yokoo, Takashi, Takafumi, Ito, Fujimoto, Shouichi, Conti, Giovanni, Santoro, Domenico, Materassi, Marco, Zhang, Hong, Shi, Sufang, Liu, Zhi-Hong, Tesar, Vladimir, Maixnerova, Dita, Avila-Casado, Carmen, Bajema, Ingeborg, Barreca, Antonella, Becker, Jan U., Comstock, Jessica M., Cornea, Virgilius, Eldin, Karen, Hernandez, Loren Herrera, Hou, Jean, Joh, Kensuke, Lin, Mercury, Messias, Nidia, Muda, Andrea Onetti, Pagni, Fabio, Diomedi-Camassei, Francesca, Tokola, Heikki, DʼArmiento, Maria, Seidl, Maximilian, Rosenberg, Avi, Sannier, Aurélie, Soares, Maria Fernanda, Wang, Suxia, Zeng, Caihong, and Haas, Mark

Published
2024
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15. Updating the International IgA Nephropathy Prediction Tool for use in children

Author

Zeng, Caihong, Su, Biage, Zhong, Xuhui, Nakanishi, Koichi, Zhai, Yihui, Urushihara, Maki, Hattori, Motoshi, Camassei, Francesca Diomedi, Barreca, Antonella, Robert, Thomas, Prikhodina, Larisa, Berg, Ulla, Topaloglu, Rezan, Mizerska-Wasiak, Malgorzata, Papagianni, Aikaterini, Bellur, Shubha S., Roberts, Ian, Barbour, Sean J., Coppo, Rosanna, Er, Lee, Russo, Maria Luisa, Liu, Zhi-Hong, Ding, Jie, Katafuchi, Ritsuko, Yoshikawa, Norishige, Xu, Hong, Kagami, Shoji, Yuzawa, Yukio, Emma, Francesco, Cambier, Alexandra, Peruzzi, Licia, Wyatt, Robert J., and Cattran, Daniel C.

Published
2021
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16. Clinicopathologic predictors of renal outcomes in light chain cast nephropathy: a multicenter retrospective study

Author

Royal, Virginie, Leung, Nelson, Troyanov, Stéphan, Nasr, Samih H., Écotière, Laure, LeBlanc, Richard, Adam, Benjamin A., Angioi, Andrea, Alexander, Mariam P., Asunis, Anna Maria, Barreca, Antonella, Bianco, Paola, Cohen, Camille, Drosou, Maria E., Fatima, Huma, Fenoglio, Roberta, Gougeon, François, Goujon, Jean-Michel, Herrera, Guillermo A., Knebelmann, Bertrand, Lepori, Nicola, Maletta, Francesca, Manso, Rita, Motwani, Shveta S., Pani, Antonello, Rabant, Marion, Rennke, Helmut G., Rocatello, Dario, Rosenblum, Frida, Sanders, Paul W., Santos, Afonso, Soto, Karina, Sis, Banu, Touchard, Guy, Venner, Christopher P., and Bridoux, Frank

Published
2020
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18. Systemic vasculitis involving the kidney: the nephropathologist's point of view

Author

L'Imperio, V, Ceola, S, Cerbelli, B, Barreca, A, Pagni, F, L'Imperio, Vincenzo, Ceola, Stefano, Cerbelli, Bruna, Barreca, Antonella, Pagni, Fabio, L'Imperio, V, Ceola, S, Cerbelli, B, Barreca, A, Pagni, F, L'Imperio, Vincenzo, Ceola, Stefano, Cerbelli, Bruna, Barreca, Antonella, and Pagni, Fabio

Abstract

Kidneys are often targets of systemic vasculitis (SVs), being affected in many different forms and representing a possible sentinel of an underlying multi-organ condition. Renal biopsy still remains the gold standard for the identification, characterization and classification of these diseases, solving complex differential diagnosis thanks to the combined application of light microscopy (LM), immunofluorescence (IF) and electron microscopy (EM). Due to the progressively increasing complexity of renal vasculitis classification systems (e.g. pauci-immune vs immune complex related forms), a clinico-pathological approach is mandatory and adequate technical and interpretative expertise in nephropathology is required to ensure the best standard of care for our patients. In this complex background, the present review aims at summarising the current knowledge and challenges in the world of renal vasculitis, unveiling the potential role of the introduction of digital pathology in this setting, from the creation of hub-spoke networks to the future application of artificial intelligence (AI) tools to aid in the diagnostic and scoring/classification process.

Published
2024

19. Histologic and Clinical Factors Associated with Kidney Outcomes in IgA Vasculitis Nephritis

Author

Barbour, S, Coppo, R, Er, L, Pillebout, E, Russo, M, Alpers, C, Fogo, A, Ferrario, F, Jennette, J, Roberts, I, Cook, H, Ding, J, Su, B, Zhong, X, Fervenza, F, Zand, L, Peruzzi, L, Lucchetti, L, Katafuchi, R, Shima, Y, Yoshikawa, N, Ichikawa, D, Suzuki, Y, Murer, L, Wyatt, R, Nelson, R, Narus, J, Wenderfer, S, Geetha, D, Daugas, E, Monteiro, R, Nakatani, S, Mastrangelo, A, Nuutinen, M, Koskela, M, Weber, L, Hackl, A, Pohl, M, Pecoraro, C, Tsuboi, N, Yokoo, T, Takafumi, I, Fujimoto, S, Conti, G, Santoro, D, Materassi, M, Zhang, H, Shi, S, Liu, Z, Tesar, V, Maixnerova, D, Avila-Casado, C, Bajema, I, Barreca, A, Becker, J, Comstock, J, Cornea, V, Eldin, K, Hernandez, L, Hou, J, Joh, K, Lin, M, Messias, N, Muda, A, Pagni, F, Diomedi-Camassei, F, Tokola, H, D’Armiento, M, Seidl, M, Rosenberg, A, Sannier, A, Soares, M, Wang, S, Zeng, C, Haas, M, Barbour, Sean J., Coppo, Rosanna, Er, Lee, Pillebout, Evangeline, Russo, Maria Luisa, Alpers, Charles E., Fogo, Agnes B., Ferrario, Franco, Jennette, J. Charles, Roberts, Ian S. D., Cook, H. Terence, Ding, Jie, Su, Baige, Zhong, Xuhui, Fervenza, Fernando C., Zand, Ladan, Peruzzi, Licia, Lucchetti, Laura, Katafuchi, Ritsuko, Shima, Yuko, Yoshikawa, Norishige, Ichikawa, Daisuke, Suzuki, Yusuke, Murer, Luisa, Wyatt, Robert J., Nelson, Raoul D., Narus, JoAnn H., Wenderfer, Scott, Geetha, Duvuru, Daugas, Eric, Monteiro, Renato C., Nakatani, Shinya, Mastrangelo, Antonio, Nuutinen, Matti, Koskela, Mikael, Weber, Lutz T, Hackl, Agnes, Pohl, Martin, Pecoraro, Carmine, Tsuboi, Nobuo, Yokoo, Takashi, Takafumi, Ito, Fujimoto, Shouichi, Conti, Giovanni, Santoro, Domenico, Materassi, Marco, Zhang, Hong, Shi, Sufang, Liu, Zhi-Hong, Tesar, Vladimir, Maixnerova, Dita, Avila-Casado, Carmen, Bajema, Ingeborg, Barreca, Antonella, Becker, Jan U., Comstock, Jessica M., Cornea, Virgilius, Eldin, Karen, Hernandez, Loren Herrera, Hou, Jean, Joh, Kensuke, Lin, Mercury, Messias, Nidia, Muda, Andrea Onetti, Pagni, Fabio, Diomedi-Camassei, Francesca, Tokola, Heikki, D’Armiento, Maria, Seidl, Maximilian, Rosenberg, Avi, Sannier, Aurélie, Soares, Maria Fernanda, Wang, Suxia, Zeng, Caihong, Haas, Mark, Barbour, S, Coppo, R, Er, L, Pillebout, E, Russo, M, Alpers, C, Fogo, A, Ferrario, F, Jennette, J, Roberts, I, Cook, H, Ding, J, Su, B, Zhong, X, Fervenza, F, Zand, L, Peruzzi, L, Lucchetti, L, Katafuchi, R, Shima, Y, Yoshikawa, N, Ichikawa, D, Suzuki, Y, Murer, L, Wyatt, R, Nelson, R, Narus, J, Wenderfer, S, Geetha, D, Daugas, E, Monteiro, R, Nakatani, S, Mastrangelo, A, Nuutinen, M, Koskela, M, Weber, L, Hackl, A, Pohl, M, Pecoraro, C, Tsuboi, N, Yokoo, T, Takafumi, I, Fujimoto, S, Conti, G, Santoro, D, Materassi, M, Zhang, H, Shi, S, Liu, Z, Tesar, V, Maixnerova, D, Avila-Casado, C, Bajema, I, Barreca, A, Becker, J, Comstock, J, Cornea, V, Eldin, K, Hernandez, L, Hou, J, Joh, K, Lin, M, Messias, N, Muda, A, Pagni, F, Diomedi-Camassei, F, Tokola, H, D’Armiento, M, Seidl, M, Rosenberg, A, Sannier, A, Soares, M, Wang, S, Zeng, C, Haas, M, Barbour, Sean J., Coppo, Rosanna, Er, Lee, Pillebout, Evangeline, Russo, Maria Luisa, Alpers, Charles E., Fogo, Agnes B., Ferrario, Franco, Jennette, J. Charles, Roberts, Ian S. D., Cook, H. Terence, Ding, Jie, Su, Baige, Zhong, Xuhui, Fervenza, Fernando C., Zand, Ladan, Peruzzi, Licia, Lucchetti, Laura, Katafuchi, Ritsuko, Shima, Yuko, Yoshikawa, Norishige, Ichikawa, Daisuke, Suzuki, Yusuke, Murer, Luisa, Wyatt, Robert J., Nelson, Raoul D., Narus, JoAnn H., Wenderfer, Scott, Geetha, Duvuru, Daugas, Eric, Monteiro, Renato C., Nakatani, Shinya, Mastrangelo, Antonio, Nuutinen, Matti, Koskela, Mikael, Weber, Lutz T, Hackl, Agnes, Pohl, Martin, Pecoraro, Carmine, Tsuboi, Nobuo, Yokoo, Takashi, Takafumi, Ito, Fujimoto, Shouichi, Conti, Giovanni, Santoro, Domenico, Materassi, Marco, Zhang, Hong, Shi, Sufang, Liu, Zhi-Hong, Tesar, Vladimir, Maixnerova, Dita, Avila-Casado, Carmen, Bajema, Ingeborg, Barreca, Antonella, Becker, Jan U., Comstock, Jessica M., Cornea, Virgilius, Eldin, Karen, Hernandez, Loren Herrera, Hou, Jean, Joh, Kensuke, Lin, Mercury, Messias, Nidia, Muda, Andrea Onetti, Pagni, Fabio, Diomedi-Camassei, Francesca, Tokola, Heikki, D’Armiento, Maria, Seidl, Maximilian, Rosenberg, Avi, Sannier, Aurélie, Soares, Maria Fernanda, Wang, Suxia, Zeng, Caihong, and Haas, Mark

Abstract

BACKGROUND: Nephritis is a common manifestation of IgA vasculitis and is morphologically indistinguishable from IgA nephropathy. While MEST-C scores are predictive of kidney outcomes in IgA nephropathy, their value in IgA vasculitis nephritis has not been investigated in large multiethnic cohorts. METHODS: Biopsies from 262 children and 99 adults with IgA vasculitis nephritis ( N =361) from 23 centers in North America, Europe, and Asia were independently scored by three pathologists. MEST-C scores were assessed for correlation with eGFR/proteinuria at biopsy. Because most patients ( N =309, 86%) received immunosuppression, risk factors for outcomes were evaluated in this group using latent class mixed models to identify classes of eGFR trajectories over a median follow-up of 2.7 years (interquartile range, 1.2-5.1). Clinical and histologic parameters associated with each class were determined using logistic regression. RESULTS: M, E, T, and C scores were correlated with either eGFR or proteinuria at biopsy. Two classes were identified by latent class mixed model, one with initial improvement in eGFR followed by a late decline (class 1, N =91) and another with stable eGFR (class 2, N =218). Class 1 was associated with a higher risk of an established kidney outcome (time to ≥30% decline in eGFR or kidney failure; hazard ratio, 5.84; 95% confidence interval, 2.37 to 14.4). Among MEST-C scores, only E1 was associated with class 1 by multivariable analysis. Other factors associated with class 1 were age 18 years and younger, male sex, lower eGFR at biopsy, and extrarenal noncutaneous disease. Fibrous crescents without active changes were associated with class 2. CONCLUSIONS: Kidney outcome in patients with biopsied IgA vasculitis nephritis treated with immunosuppression was determined by clinical risk factors and endocapillary hypercellularity (E1) and fibrous crescents, which are features that are not part of the International Study of Diseases of Children classificatio

Published
2024

21. Application of the updated International IgA Nephropathy Prediction Tool in children one or two years post-biopsy

Author

Barbour, Sean J., Coppo, Rosanna, Er, Lee, Russo, Maria Luisa, Liu, Zhi-Hong, Ding, Jie, Zhong, Xuhui, Katafuchi, Ritsuko, Yoshikawa, Norishige, Xu, Hong, Kagami, Shoji, Yuzawa, Yukio, Emma, Francesco, Cambier, Alexandra, Peruzzi, Licia, Wyatt, Robert J., Cattran, Daniel C., Zeng, Caihong, Su, Biage, Zhong, Xuhui, Nakanishi, Koichi, Zhai, Yihui, Urushihara, Maki, Hattori, Motoshi, Camassei, Francesca Diomedi, Barreca, Antonella, Robert, Thomas, Prikhodina, Larisa, Berg, Ulla, Topaloglu, Rezan, Mizerska-Wasiak, Malgorzata, Papagianni, Aikaterini, Bellur, Shubha S., and Roberts, Ian

Abstract

The pediatric International IgA Nephropathy (IgAN) Prediction Tool comprises two models with and without ethnicity and is the first method to predict the risk of a 30% decline in estimated glomerular filtration rate (eGFR) or kidney failure in children at the time of biopsy using clinical risk factors and Oxford MEST histology scores. However, it is unknown if the Prediction Tool can be applied after a period of observation post-biopsy. Using an international multi-ethnic cohort of 947 children with IgAN, 38% of whom were followed into adulthood, the Prediction Tool was updated for use one year after biopsy. Compared to the original pediatric Prediction Tool, the updated post-biopsy Prediction Tool had a better model fit with higher R2D(51%/50% vs 20%), significant increase in 4-year C-statistics (0.83 vs 0.73/0.69, ΔC 0.09 [95% confidence interval 0.07-0.10] and ΔC 0.14 [0.12-0.15]) and better 4-year calibration with lower integrated calibration indices (0.74/0.54 vs 2.45/1.01). Results were similar after internal validation and when the models were applied two years after biopsy. Trajectories of eGFR after a baseline one year post-biopsy were non-linear and those at higher predicted risk started with a lower eGFR and experienced a more rapid decline over time. In children, eGFR had a variable rate of increase until 15-18 years old and then decreased linearly with a more rapid decline in higher risk groups that was similar to young adults of comparable risk. Thus, the original pediatric Prediction Tool should be used in children at the time of biopsy, and the updated pediatric Prediction Tool should be used to re-evaluate risk one or two years after biopsy.

Published
2024
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22. Rescue with obinutuzumab and daratumumab as combined B cell/plasma cell targeting approach in severe posttransplant focal segmental glomerulosclerosis recurrence

Author

Randone, Paolo, Sanna, Enrico, Dolla, Caterina, Gallo, Ester, Mingozzi, Silvia, Tarragoni, Rita, Torazza, Maria Cristina, Niarchos, Anna, Mella, Alberto, Manzione, Ana Maria, Barreca, Antonella, Deambrosis, Ilaria, Giraudi, Roberta, and Biancone, Luigi

Abstract

The recurrence of primary focal segmental glomerulosclerosis (FSGS) after kidney transplantation is associated with a high graft loss rate with standard treatments based on plasmapheresis with/without rituximab. We present 2 consecutive cases of nongenetic early severe recurrent FSGS refractory to rituximab and anti–interleukin 1 treatment and with a partial response to plasmapheresis. Case 1 was a 22-year-old man who was rescue-treated for recurrence 36 weeks after transplantation with obinutuzumab (1000 mg/1.73 m2, 1 dose) and daratumumab (18 mg/kg each dose, 8 doses), resulting in plasmapheresis discontinuation and a drop of proteinuria from 29 to 2.3 g/d. Proteinuria increased with circulating CD38+plasma cells and responded to an additional daratumumab dose. Currently, the proteinuria is 1.8 g/d, 14.5 months after discontinuing plasmapheresis and starting obinutuzumab and daratumumab therapy. Case 2 was a 15-year-old girl who was plasmapheresis dependent with 2 g/d proteinuria 82 weeks after transplantation, with a Tesio catheter in the right jugular vein as the only possible vascular access. After treatment with obinutuzumab and daratumumab (1 dose each), she achieved stable complete remission (0.3 g/d proteinuria) with persistent plasmapheresis discontinuation. These cases suggest the potential of combining obinutuzumab with daratumumab for the treatment of recurrent FSGS.

Published
2024
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23. Acute Transient Hyperglycemia After Steroid Induction at Transplant Strongly Predicts New-Onset Diabetes and Recurrence of Diabetic Nephropathy

Author

Zizzi, Carlotta Federica, primary, Dolla, Caterina, additional, Fop, Fabrizio, additional, Mella, Alberto, additional, Sandrone, Michela, additional, Ghigo, Ezio, additional, Bertaina, Silvana, additional, Broglio, Fabio, additional, Gallo, Ester, additional, Barreca, Antonella, additional, Beccuti, Guglielmo, additional, Veglio, Franco, additional, Milan, Alberto, additional, Lavacca, Antonio, additional, Giraudi, Roberta, additional, and Biancone, Luigi, additional

Published
2024
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24. Histology for nephrology, from pre-implantation to post-transplant kidney biopsy. Lesson learned from ReBIrth (Renal BIopsy for Kidney Transplantation Therapy)

Author

Caliò, Anna, primary, Barreca, Antonella, additional, Marletta, Stefano, additional, Achenza, Maria Italia Sara, additional, Alessi, Marianna, additional, Angelico, Roberta, additional, Apicella, Luca, additional, Argiolas, Davide, additional, Bossini, Nicola, additional, Carrano, Rosa, additional, Carriero, Concetta, additional, Castellano, Giuseppe, additional, Comai, Giorgia, additional, Di Bella, Caterina, additional, D’Ignoto, Francesco, additional, Gallico, Agnese, additional, Gastaldon, Fiorella, additional, Merlotti, Guido, additional, Paloschi, Vera, additional, Panarese, Alessandra, additional, Parodi, Angelica, additional, Perna, Francesco, additional, Picciotto, Daniela, additional, Regalia, Anna, additional, Rossini, Michele, additional, Russo, Enrico, additional, Salerno, Maria Paola, additional, Toti, Luca, additional, Tulissi, Patrizia, additional, Vischini, Gisella, additional, Zaza, Gianluigi, additional, and Eccher, Albino, additional

Published
2023
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26. Identification of a new subclass of ALK-negative ALCL expressing aberrant levels of ERBB4 transcripts

Author

Scarfò, Irene, Pellegrino, Elisa, Mereu, Elisabetta, Kwee, Ivo, Agnelli, Luca, Bergaggio, Elisa, Garaffo, Giulia, Vitale, Nicoletta, Caputo, Manuel, Machiorlatti, Rodolfo, Circosta, Paola, Abate, Francesco, Barreca, Antonella, Novero, Domenico, Mathew, Susan, Rinaldi, Andrea, Tiacci, Enrico, Serra, Sara, Deaglio, Silvia, Neri, Antonino, Falini, Brunangelo, Rabadan, Raul, Bertoni, Francesco, Inghirami, Giorgio, and Piva, Roberto

Published
2016
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28. Segmentation of diagnostic tissue compartments on whole slide images with renal thrombotic microangiopathies (TMAs)

Author

Vo, Huy Q., Cicalese, Pietro A., Seshan, Surya, Rizvi, Syed A., Vathul, Aneesh, Bueno, Gloria, Dorado, Anibal Pedraza, Grabe, Niels, Stolle, Katharina, Pesce, Francesco, Roelofs, Joris J. T. H., Kers, Jesper, Bevilacqua, Vitoantonio, Altini, Nicola, Schröppel, Bernd, Roccatello, Dario, Barreca, Antonella, Sciascia, Savino, Mohan, Chandra, Nguyen, Hien V., Becker, Jan U., Vo, Huy Q., Cicalese, Pietro A., Seshan, Surya, Rizvi, Syed A., Vathul, Aneesh, Bueno, Gloria, Dorado, Anibal Pedraza, Grabe, Niels, Stolle, Katharina, Pesce, Francesco, Roelofs, Joris J. T. H., Kers, Jesper, Bevilacqua, Vitoantonio, Altini, Nicola, Schröppel, Bernd, Roccatello, Dario, Barreca, Antonella, Sciascia, Savino, Mohan, Chandra, Nguyen, Hien V., and Becker, Jan U.

Abstract

The thrombotic microangiopathies (TMAs) manifest in renal biopsy histology with a broad spectrum of acute and chronic findings. Precise diagnostic criteria for a renal biopsy diagnosis of TMA are missing. As a first step towards a machine learning- and computer vision-based analysis of wholes slide images from renal biopsies, we trained a segmentation model for the decisive diagnostic kidney tissue compartments artery, arteriole, glomerulus on a set of whole slide images from renal biopsies with TMAs and Mimickers (distinct diseases with a similar nephropathological appearance as TMA like severe benign nephrosclerosis, various vasculitides, Bevacizumab-plug glomerulopathy, arteriolar light chain deposition disease). Our segmentation model combines a U-Net-based tissue detection with a Shifted windows-transformer architecture to reach excellent segmentation results for even the most severely altered glomeruli, arterioles and arteries, even on unseen staining domains from a different nephropathology lab. With accurate automatic segmentation of the decisive renal biopsy compartments in human renal vasculopathies, we have laid the foundation for large-scale compartment-specific machine learning and computer vision analysis of renal biopsy repositories with TMAs., Comment: 12 pages, 3 figures

Published
2023

29. The need for kidney biopsy in the management of side effects of target and immunotherapy

Author

Fenoglio, Roberta, Cozzi, Martina, Del Vecchio, Giulio, Sciascia, Savino, Barreca, Antonella, Comandone, Alessandro, and Roccatello, Dario

Abstract

IntroductionThe introduction of innovative therapies, resulting from revisiting cancer as a disease of the immune system, has changed the scenario of complications. These new classes of drugs, such as targeted therapies and immune checkpoint inhibitors, assure substantial advantages in cancer therapy, despite some side effects affecting various organs, including the kidney. Histological evaluations of kidney disorders induced by targeted/immunotherapy are limited.MethodIn this study we examined the histological features of patients treated with new cancer agents who underwent a kidney biopsy for new onset kidney failure and/or urinary abnormalities.ResultsThe cohort included 30 adult patients. The most frequently administered therapies were immunotherapy (30%), targeted therapy (26.7%), immunotherapy plus targeted therapy (13.3%), immunotherapy plus chemotherapy (13.3%), targeted therapy plus chemotherapy (16.7%). The most common histological finding was tubular interstitial nephritis (30%) that was associated with acute tubular necrosis in 4 cases, and thrombotic microangiopathy (23.3%). After kidney biopsy, 16 of the 30 patients were treated according to the histological diagnosis. Fourteen patients were treated with steroids. One patient with membranous nephropathy was treated with a single dose of rituximab. A patient with severe thrombotic microangiopathy requiring dialysis received a treatment with eculizumab for 3 months. Overall some renal response was obtained in all patients treated with glucocorticoids, while complete kidney response was achieved in the patient treated with rituximab. Cancer treatment was resumed without change in 21 out of 30 patients.ConclusionKidney biopsy is critical for the management of kidney toxicities and should be strongly encouraged for patients showing adverse kidney effects of novel cancer agents.

Published
2023
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30. Histology for nephrology, from pre-implantation to post-transplant kidney biopsy. Lesson learned from ReBIrth (Renal BIopsy for Kidney Transplantation Therapy)

Author

Caliò, Anna, Barreca, Antonella, Marletta, Stefano, Achenza, Maria Italia Sara, Alessi, Marianna, Angelico, Roberta, Apicella, Luca, Argiolas, Davide, Bossini, Nicola, Carrano, Rosa, Carriero, Concetta, Castellano, Giuseppe, Comai, Giorgia, Di Bella, Caterina, D'Ignoto, Francesco, Gallico, Agnese, Gastaldon, Fiorella, Merlotti, Guido, Paloschi, Vera, Panarese, Alessandra, Parodi, Angelica, Perna, Francesco, Picciotto, Daniela, Regalia, Anna, Rossini, Michele, Russo, Enrico, Salerno, Maria Paola, Toti, Luca, Tulissi, Patrizia, Vischini, Gisella, Zaza, Gianluigi, and Eccher, Albino

Subjects
whole-slide imaging, immunosuppression, kidney biopsy, kidney transplantation, digital pathology
Published
2023

35. Focal segmental glomerular sclerosis can be effectively treated using an intensive B-cell depletion therapy.

Author

Roccatello, Dario, Baffa, Alessandra, Naretto, Carla, Barreca, Antonella, Cravero, Raffaella, Roscini, Elisabetta, Sciascia, Savino, and Fenoglio, Roberta

Subjects
GLOMERULOSCLEROSIS, FOCAL segmental glomerulosclerosis, KIDNEY failure, NEPHROTIC syndrome, RITUXIMAB, DISEASE relapse
Abstract

Background Focal segmental glomerular sclerosis (FSGS) is a histologic lesion rather than a specific disease entity and represents a cluster of different conditions affecting both children and adults that includes primary, secondary and genetically mediated forms. These forms can be distinguished by electron microscopy and genetic assessment and show different responsiveness to steroids and immunosuppressants. Despite some promising effects of rituximab in nephrotic syndrome in children, the results in adults with FSGS are disappointing. Our group previously explored the effectiveness of rituximab in eight adult patients with unselected forms of FSGS and achieved a consistent reduction in proteinuria in one case. Following this experience, we developed an alternative therapeutic option intended to enhance the potential of rituximab with the support of other synergic drugs. We herein report the results of this therapeutic protocol (six administrations of rituximab plus two of intravenous cyclophosphamide plus glucocorticoids) in seven prospectively enrolled patients with extensive podocyte effacement and recurrent relapses or steroid dependence. Results Patients had a median baseline serum creatinine level of 2.2 mg/dl (range 1–4.7) that decreased to 1.1 mg/dl (range 0.9–2.2) and 1.1 mg/dl (range 0.75–2.21) after 3 and 6 months, respectively, and remained unchanged at 12 months. Three of five patients with renal failure turned to normal function while the other two patients maintained a stable impairment after 18 and 52 months. The median proteinuria decreased from 6.1 g/24 h to 3.5, 3.5 and 1.9 g/24 h at 3, 6 and 12 months, respectively. Specifically, five of seven patients had a partial response at 12 months and became non-nephrotic. One of them had a complete response at 18 months and was still in complete remission at the last follow-up visit at 36 months. Proteinuria persisted unchanged in two of seven patients with a genetic-related disease. No serious late adverse events were observed. Conclusions Our results show that intensive B-cell depletion therapy is able to reverse the nephrotic syndrome of steroid-dependent or frequently relapsing adult patients with putatively idiopathic FSGS (i.e. with extensive podocyte effacement). [ABSTRACT FROM AUTHOR]

Published
2023
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37. DNAJB9 Is a Reliable Immunohistochemical Marker of Fibrillary Glomerulonephritis: Evaluation of Diagnostic Efficacy in a Large Series of Kidney Biopsies

Author

Gambella, Alessandro, primary, Pitino, Chiara, additional, Barreca, Antonella, additional, Nocifora, Alberto, additional, Giarin, Manuela Maria, additional, Bertero, Luca, additional, Biancone, Luigi, additional, Roccatello, Dario, additional, Papotti, Mauro, additional, and Cassoni, Paola, additional

Published
2022
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40. Treating Patients With ANCA-Associated Vasculitis and Very Severe Renal Injury With an Intensified B Cell Depletion Therapy: Comparison With a Control Cohort Receiving a Conventional Therapy

Author

Roccatello, Dario, primary, Sciascia, Savino, additional, Murgia, Stefano, additional, Quattrocchio, Giacomo, additional, Ferro, Michela, additional, De Simone, Emanuele, additional, Naretto, Carla, additional, Barreca, Antonella, additional, Sammartino, Andrea, additional, Rossi, Daniela, additional, and Fenoglio, Roberta, additional

Published
2022
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43. The Matter of Kidney Biopsy in Monoclonal Gammopathy of Renal Significance: A Case Report of a New Pattern of Immunoglobulin-Storing Histiocytosis.

Author

Randone, Paolo, Burdese, Manuel, Barreca, Antonella, Oliva, Stefania, Sanna, Enrico, Abbasciano, Isabella, Anania, Patrizia, Boaglio, Elena, and Biancone, Luigi

Subjects
RENAL biopsy, HISTIOCYTOSIS, MONOCLONAL gammopathies, ERDHEIM-Chester disease, MULTIPLE myeloma, LYMPHOPROLIFERATIVE disorders, BONE marrow
Abstract

Monoclonal gammopathy of renal significance (MGRS) represents a group of disorders, characterized by paraproteinemia which causes renal damage. These disorders never meet the diagnostic criteria for multiple myeloma (MM) or lymphoproliferative disease. Crystal-storing histiocytosis is one of the rarest patterns of MGRS, characterized by an accumulation of light chains of crystals within histiocyte's cytoplasm, located in bone marrow or other extramedullary sites such as the kidney, cornea, or thyme. A very few cases have been described as immunoglobulin-storing histiocytosis (IgSH) without evidence of crystals. In the recent literature, only 3 cases of IgSH have been described so far, none renal. In all cases, these very peculiar histopathological patterns are associated with lymphoproliferative or plasma cellular disorders. Here, we report a very unusual IgSH pattern in a kidney biopsy, which led to prompt detection and early therapeutic intervention, in a patient with otherwise misdiagnosed MGRS. [ABSTRACT FROM AUTHOR]

Published
2023
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45. Caveolin-1 in Kidney Chronic Antibody-Mediated Rejection: An Integrated Immunohistochemical and Transcriptomic Analysis Based on the Banff Human Organ Transplant (B-HOT) Gene Panel

Author

Gambella, Alessandro, primary, Barreca, Antonella, additional, Osella-Abate, Simona, additional, Bottasso, Emanuel, additional, Giarin, Manuela Maria, additional, Papotti, Mauro, additional, Biancone, Luigi, additional, Metovic, Jasna, additional, Collemi, Giammarco, additional, Cassoni, Paola, additional, and Bertero, Luca, additional

Published
2021
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49. Updating the International IgA Nephropathy Prediction Tool for use in children

Author

Barbour, Sean J., primary, Coppo, Rosanna, additional, Er, Lee, additional, Russo, Maria Luisa, additional, Liu, Zhi-Hong, additional, Ding, Jie, additional, Katafuchi, Ritsuko, additional, Yoshikawa, Norishige, additional, Xu, Hong, additional, Kagami, Shoji, additional, Yuzawa, Yukio, additional, Emma, Francesco, additional, Cambier, Alexandra, additional, Peruzzi, Licia, additional, Wyatt, Robert J., additional, Cattran, Daniel C., additional, Zeng, Caihong, additional, Su, Biage, additional, Zhong, Xuhui, additional, Nakanishi, Koichi, additional, Zhai, Yihui, additional, Urushihara, Maki, additional, Hattori, Motoshi, additional, Camassei, Francesca Diomedi, additional, Barreca, Antonella, additional, Robert, Thomas, additional, Prikhodina, Larisa, additional, Berg, Ulla, additional, Topaloglu, Rezan, additional, Mizerska-Wasiak, Malgorzata, additional, Papagianni, Aikaterini, additional, Bellur, Shubha S., additional, and Roberts, Ian, additional

Published
2021
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50. Protective Role of the M-Sec–Tunneling Nanotube System in Podocytes

Author

Barutta, Federica, primary, Kimura, Shunsuke, additional, Hase, Koji, additional, Bellini, Stefania, additional, Corbetta, Beatrice, additional, Corbelli, Alessandro, additional, Fiordaliso, Fabio, additional, Barreca, Antonella, additional, Papotti, Mauro Giulio, additional, Ghiggeri, Gian Marco, additional, Salvidio, Gennaro, additional, Roccatello, Dario, additional, Audrito, Valentina, additional, Deaglio, Silvia, additional, Gambino, Roberto, additional, Bruno, Stefania, additional, Camussi, Giovanni, additional, Martini, Miriam, additional, Hirsch, Emilio, additional, Durazzo, Marilena, additional, Ohno, Hiroshi, additional, and Gruden, Gabriella, additional

Published
2021
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