Abatacept in B7-1-positive proteinuric kidney disease.

Yu, Chih-Chuan; Fornoni, Alessia; Weins, Astrid; Hakroush, Samy; Maiguel, Dony; Sageshima, Junichiro; Chen, Linda; Ciancio, Gaetano et al. · N Engl J Med · 2013

case_series · Level IV

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Abstract

Abatacept (cytotoxic T-lymphocyte-associated antigen 4-immunoglobulin fusion protein [CTLA-4-Ig]) is a costimulatory inhibitor that targets B7-1 (CD80). The present report describes five patients who had focal segmental glomerulosclerosis (FSGS) (four with recurrent FSGS after transplantation and one with primary FSGS) and proteinuria with B7-1 immunostaining of podocytes in kidney-biopsy specimens. Abatacept induced partial or complete remissions of proteinuria in these patients, suggesting that B7-1 may be a useful biomarker for the treatment of some glomerulopathies. Our data indicate that abatacept may stabilize β1-integrin activation in podocytes and reduce proteinuria in patients with B7-1-positive glomerular disease.

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