GLOMERULAR TRANSCRIPTOME ANALYSIS REVEALS ENDOTHELIAL DISTURBANCES IN PATIENTS WITH IDIOPATHIC NEPHROTIC SYNDROME

 

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GLOMERULAR TRANSCRIPTOME ANALYSIS REVEALS ENDOTHELIAL DISTURBANCES IN PATIENTS WITH IDIOPATHIC NEPHROTIC SYNDROME

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Gabriel
Cara Fuentes
Sara Nelson-Taylor Sarah.Nelson-Taylor@childrenscolorado.org University of Colorado Pediatric Nephrology Denver United States -
John Troost troostj@med.umich.edu University of Michigan Biostatistics Ann Arbor United States -
Courtney Giannini Courtney.Giannini@childrenscolorado.org University of Colorado Pediatric Nephrology Denver United States -
Jarcy Zee Jarcy.Zee@Pennmedicine.upenn.edu University of Pennsylvania Biostatistics Philadelphia United States -
Laura Barisoni laura.barisoni@duke.edu Duke University Nephrology Durham United States -
Ilse Daehn ilse.daehn@mssm.edu Icahn School of Medicine Nephrology New York United States -
Audrey Fetsko Audrey.Fetsko@nationwidechildrens.org Nationwide Children's Hospital Nephrology Columbus United States -
Imtiaz Islam MdImtiazul.Islam@nationwidechildrens.org Nationwide Children's Hospital Nephrology Columbus United States -
Xin Wang Xin.Wang@nationwidechildrens.org Nationwide Children's Hospital Nephrology Columbus United States -
Richard Johnson richard.johnson@cuanschutz.edu University of Colorado Nephrology Denver United States -
Carmen de Lucas-Collantes mcdelucas@yahoo.es Hospital Niño Jesus Nephrology Madrid Spain -
Kazunari Kaneko kaneko.kaz@kmu.ac.jp Kansai Medical School Pediatric Nephrology Osaka Japan -
Gabriel Cara Fuentes gabriel.carafuentes@nationwidechildrens.org Nationwide Children's Hospital Nephrotology Columbus United States *
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Idiopathic nephrotic syndrome (INS) is viewed as a podocyte-specific disease. Recent reports indicate endothelial involvement, but its significance is unclear.  Here, we investigated the relationship between the glomerular expression of selected genes relevant to endothelial health and clinical markers of disease severity.     

We analyzed publicly available RNA seq data from micro-dissected human glomeruli performed by the NEPTUNE consortium. Because our group previously showed evidence of endothelial glycocalyx injury and endothelial activation, this study focused on 10 genes highly relevant for endothelial homeostasis and barrier integrity (NOS3, ESAM, ESM1), endothelial glycocalyx remodeling (HPSE, HYAL1, MMP2, MMP9, ADAMTS1) and endothelial activation (ICAM1, CAV1). The population included 153 patients with INS (n=70 minimal change disease [MCD] and n=83 focal segmental glomerulosclerosis [FSGS]) from the NEPTUNE cohort study and 53 control participants. Validation studies, including animal and cell culture experiments, were performed. Relationship between gene expression and clinical features (kidney function, ultrastructural changes in podocytes and glomerular endothelium, interstitial fibrosis and tubular atrophy [IF/TA] was studied using one-way ANOVA and Tukey’s multiple comparisons test Pearson Correlation and Cohen’s d statistics.

Transcriptomic analysis revealed that all genes of interest were highly expressed in glomeruli from INS patients compared to controls, except for ESM1 and MMP9 which were decreased. Expression of endothelial-specific genes correlated with those of glycocalyx injury and cell activation. HPSE, ADAMTS1, ICAM1, and CAV1 expression was inversely associated with kidney function, whereas ADAMTS1 showed a positive association with proteinuria. NOS3, HPSE and ADAMTS1 associated with podocyte foot process effacement and ICAM1 with podocyte detachment. HPSE and MMP2 associated with ultrastructural endothelial injury, whereas HPSE, MMP2, ICAM1 and CAV1 associated with IF/TA. Several genes (ESM1, HPSE, HYAL1, MMP2, and ICAM1) were also dysregulated in experimental INS, and validated in cultured glomerular endothelial cells (NOS3 and heparanase) following exposure to INS sera.

INS involves dysregulation of genes relevant for endothelial health.

Kewords