IWG newsletter
Immunonephrology Working Group Newsletter, No. 2, January 2015

Dear Friends,

In September 2014 we published our first newsletter providing some basic information on the activities of the ERA-EDTA Immunonephrology Working Group, namely on ERA-EDTA sponsored VALIGA studies, Post-VALIGA projects and imulsion grants provided by IWG.

This second newsletter concentrates on recently published paper discovering new genes relating IgA nephropathy to the immunity to intestinal pathogens , recent  IWG search for  renal biopsy patterns and epidemiology of glomerular disease and hint to the announcement of the CME course on biomarkers in glomerular disease we organize in Istanbul in early March 2015.

You are warmly welcomed to join us in IWG and to participate in our CME course.

Rosanna Coppo,  Chairman of Immunonephrology Working Group
Mohamed R.Daha, Secretary of the Immunonephrology Working Group

1. Newly discovered risk loci for IgA nephropathy implicate genes involved in imunity against intestinal pathogens

Recently published by far the largest genome-wide association study (GWAS) of IgA nephropathy in 20,612 European and East Asian patients (1)  identified six new significant genome-wide associations (in the genes ITGAM-ITGAX, VAV3, CARD9, HLA-DQB1 and DEFA) and replicated the previously identified signals. Cumulative genetic burden was strongly associated with age and disease onset and most genes identified genes were associated with the risk of intestinal inflammation, intestinal immunity response to mucosal pathogens and/or the maintenance of intestinal epithelial barrier. The authors stress that the genetic risk strongly correlates with variation in local pathogens, namely helminth diversity. The geospatial distribution of risk alleles suggests that the increased genetic risk of IgA nephropathy may be a trade-off the  adapation to intestinal pathogens.

The paper contributes not only to better understanding of the pathogenesis of IgA nephropathy, but paves also the way for new potential modes of treatment  aimed at intestinal immunity and integrity of intestinal epithelial barrier.

1.
Kiryluk,K., Scolari,F., Sanna-Cherchi,S., et al.: Discovery of new riks loci for IgA nephropathy implicates genes involved in imunity against intestinal pathogens. Nat. Genet., 2014, 46: 1187 – 1196.
2. European survey on the methodology of renal biopsy in adult patients

In collaboration with European Society of Pediatric Nephrology (ESPN) Immunonephrology Working group performed an analysis of practice patterns of renal biopsy in pediatric and adult patients with renal disease. A filled questionnaire was obtained altogether from 629 renal centres all over Europe and from several extra-European countries. Results from 250 adult and 220 pediatric European centres were analyzed and submitted by  Alessandro Amore as an abstract for the ERA-EDTA meeting in London. 
   
Questionnaire provides a detailed information on the methodology of renal biopsy in large (less than 10% of centres performing more than 150 renal biopsies annually) and smaller centres demonstrating the increasing role of ultrasound guidance (often in cooperation with radiologists), use of automatic needles, perprocedural evaluation of the quality of the sample, prevailing overnight stay in the hospital after renal biopsy and low rate of serious complications.  These data may help to compare the practice patterns in different parts of Europe.

3. ERA-EDTA CME course „Glomerulonephritis and novel biomarkers“, March 6-7, Istanbul, Turkey

Joint meeting of IWG,   Young Investigator Platform of ERA-EDTA and Turkish Society of Nephrology will take place in Istanbul on March 6-7, 2015. The meeting is dedicated to the role of genetic, serologic, urinary and histopathologic biomarkers in the activity and outcome of different primary and secondary glomerulonephritides, including IgA nephropathy, ANCA-associated vasculitis, lupus nephritis, minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, renal amyloidosis, membranoproliferative glomerulonefritis and atypical hemolytic uremic syndrome. Programme of the meeting is available on the website:
http://www.ndt-educational.org/cme2015/Glomerulonephritis_novel_biomarkers_programme.pdf

Report prepared by:  Vladimir Tesar, IWG Board Member