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  • Title: Prediction of corticosteroid responsiveness based on fibroblast-specific protein 1 (FSP1) in patients with IgA nephropathy.
    Author: Harada K, Akai Y, Yamaguchi Y, Kimura K, Nishitani Y, Nakatani K, Iwano M, Saito Y.
    Journal: Nephrol Dial Transplant; 2008 Oct; 23(10):3152-9. PubMed ID: 18463322.
    Abstract:
    BACKGROUND: Corticosteroids are frequently used to treat patients with active IgA nephropathy (IgAN); however, there have been few reports describing factors that are predictive of the response to corticosteroid treatment. The purpose of this study is to determine the extent to which fibroblast-specific protein 1-positive (FSP1(+)) cells are predictive of corticosteroid responsiveness in patients with IgAN. METHODS: Fifty biopsy-proven IgAN patients who received corticosteroid therapy were enrolled and followed for 7.1 +/- 3.0 years. FSP1(+) cells were identified using an anti-FSP1 antibody. RESULTS: Twelve patients showed progression of renal impairment or no reduction of urinary protein (non-responders) after steroid therapy. In the remaining 38 patients, renal function was stable during follow-up, and their urinary protein declined to <1.0 g/day (responders). Serum creatinine, estimated GFR, severity of mesangial proliferation, percent glomerulosclerosis/total glomeruli, extent of interstitial damage and FSP1(+) cell number were all significantly higher in non-responders than in responders. Cox regression analysis using two covariates with every possible combination of factors indicated that FSP1(+) cell number was the strongest and most significant predictor of corticosteroid responsiveness. When IgAN patients had >32.6 FSP1(+) cells/HPF at diagnosis, they were the more likely to show steroid resistance. CONCLUSION: FSP1(+) cell number can serve as an excellent predictor of corticosteroid responsiveness in patients with IgAN.
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