Using a Podocyte Marker to Stain Nephron

The Filtrate:

Joel Topf

Jennie Lin

Joshua Waitzman

Nayan Arora

Sophia Ambruso

Special Guest:

Astrid Weins (@AstridWeins) renal pathologist at the Brigham and Woman’s Hospital and Harvard Medical School

Editor:

Nayan Aurora

Show Notes:

Summary of minimal change disease according to the orthodoxy: Light microscopy of renal biopsy specimens from patients with MCD shows minimal to no change; however, electron microscopy reveals the effacement of podocyte foot processes. To add to the conundrum, immunofluorescent staining of biopsy specimens is negative, and no immune complexes are evident.

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Most of these patients have a homozygous truncating mutation (Fin-major mutation) in the nephrin gene (NPHS1), leading to total absence of the major podocyte protein, nephrin. After RTx, these patients develop anti-nephrin antibodies resulting in nephrotic range proteinuria.

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Dr. Laurence Beck and the discovery of Phospholipase A2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy as published in the NEJM.

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