000169948 001__ 169948
000169948 005__ 20260306154908.0
000169948 0247_ $$2doi$$a10.1016/j.ekir.2026.103794
000169948 0248_ $$2sideral$$a148447
000169948 037__ $$aART-2026-148447
000169948 041__ $$aeng
000169948 100__ $$aHengel, Felicitas E.
000169948 245__ $$aEffect of Steroids on Anti-nephrin Autoantibodies and B cells in Minimal Change Disease
000169948 260__ $$c2026
000169948 5060_ $$aAccess copy available to the general public$$fUnrestricted
000169948 5203_ $$aIntroduction
The identification of autoantibodies against nephrin, a key signaling protein of the podocyte slit diaphragm, and their pathogenic role in patients with minimal change disease (MCD) has substantially changed our understanding of primary podocytopathies. However, details on underlying immune pathophysiological mechanisms such as the relation of anti-nephrin autoantibodies with immune cell subsets and therapy response remain to be determined.
Methods
In this prospective study, we evaluated blood samples from adults with newly diagnosed, biopsy-proven MCD for circulating anti-nephrin antibodies using immunoprecipitation (IP) and B-cell subpopulations by fluorescence-activated cell sorting. Samples were collected at diagnosis (t0) and after 8 weeks of steroid therapy (t1).
Results
We detected anti-nephrin antibodies in 12 of 17 (70.6%) therapy-naïve patients with MCD at t0. All 12 patients (100%) positive for anti-nephrin antibodies achieved complete remission with no anti-nephrin antibodies detectable after 8 weeks of steroid treatment (t1). Two of 5 anti-nephrin negative patients (40%) did not reach clinical remission at t1. Anti-nephrin positive patients exhibited a larger fraction of plasmablasts than anti-nephrin negative patients at t0, albeit not statistically significant. Plasmablasts, naïve B cells, and transitional B cells significantly decreased, whereas marginal zone–like B cells increased within 8 weeks of steroid treatment in anti-nephrin positive patients (t1).
Conclusion
Our study shows, for the first time, a therapeutically relevant short-term effect of steroids on the B-cell compartment and anti-nephrin antibody levels, explaining the high clinical response rate in patients with anti-nephrin-associated MCD.
000169948 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000169948 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000169948 700__ $$aBeldi-Ferchiou, Asma
000169948 700__ $$aSakhi, Hamza
000169948 700__ $$aLiaukouskaya, Nastassia
000169948 700__ $$aDehde, Silke
000169948 700__ $$aKarras, Alexandre
000169948 700__ $$aEsteve, Emmanuel
000169948 700__ $$aOniszczuk, Julie
000169948 700__ $$aLe Gouvello, Sabine
000169948 700__ $$0(orcid)0000-0002-4665-9674$$aHerrera Marcos, Luis$$uUniversidad de Zaragoza
000169948 700__ $$aJoher, Nizar
000169948 700__ $$aDaugas, Eric
000169948 700__ $$aZaidan, Mohamad
000169948 700__ $$aEl Karoui, Khalil
000169948 700__ $$aKnebelmann, Bertrand
000169948 700__ $$aDao, Myriam
000169948 700__ $$aMoktefi, Anissa
000169948 700__ $$aSahali, Dil
000169948 700__ $$aHuber, Tobias B.
000169948 700__ $$aOllero, Mario
000169948 700__ $$aTomas, Nicola M.
000169948 700__ $$aAudard, Vincent
000169948 7102_ $$11012$$2315$$aUniversidad de Zaragoza$$bDpto. Farmac.Fisiol.y Med.L.F.$$cÁrea Farmacología
000169948 773__ $$g11, 4 (2026), 103794 [11 pp.]$$pKidney int. rep.$$tKidney International Reports$$x2468-0249
000169948 8564_ $$s2565418$$uhttps://zaguan.unizar.es/record/169948/files/texto_completo.pdf$$yVersión publicada
000169948 8564_ $$s2886405$$uhttps://zaguan.unizar.es/record/169948/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000169948 909CO $$ooai:zaguan.unizar.es:169948$$particulos$$pdriver
000169948 951__ $$a2026-03-06-14:51:07
000169948 980__ $$aARTICLE