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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;
- Faridi, Mohd Hafeez;
- Behr, Daniel;
- Campbell, Kirk N;
- Chang, Jer-Ming;
- Chen, Hung-Chun;
- Oh, Jun;
- Faul, Christian;
- Arnaout, M Amin;
- Fiorina, Paolo;
- Gupta, Vineet;
- Greka, Anna;
- Burke, George W;
- Mundel, Peter
Published Web Location
https://doi.org/10.1056/nejmoa1304572Abstract
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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