Correlation of Serum Galactose-Deficient IgA1 and Oxford Class in Cases of IgA Nephropathy

Monika Shukla; Kiran Preet Malhotra; Abhilash Chandra; Namrata Sarvepalli Rao; Mohammad Kaleem Ahmad

doi:10.5858/arpa.2023-0190-OA

Correlation of Serum Galactose-Deficient IgA1 and Oxford Class in Cases of IgA Nephropathy

Arch Pathol Lab Med. 2024 Jan 30. doi: 10.5858/arpa.2023-0190-OA. Online ahead of print.

Authors

Monika Shukla¹, Kiran Preet Malhotra¹, Abhilash Chandra², Namrata Sarvepalli Rao², Mohammad Kaleem Ahmad³

Affiliations

¹ From the Departments of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India (Shukla, Malhotra).
² From the Departments of Nephrology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India (Chandra, Rao).
³ Department of Biochemistry, King George's Medical University, Lucknow, India (Ahmad).

PMID: 38289288
DOI: 10.5858/arpa.2023-0190-OA

Abstract

Context.—: Galactose-deficient immunoglobulin A1 (Gd-IgA1) deposition in the renal mesangium plays a role in the pathogenesis of IgA nephropathy.

Objective.—: To assess the serum Gd-IgA1 level in biopsy-proven IgA nephropathy cases on diagnosis and 3 months post treatment and its relation with histologic Oxford classification.

Design.—: In this hospital-based prospective cohort study, 40 cases and 20 controls were enrolled. Serum samples of biopsy-proven IgA nephropathy cases collected on the day of biopsy and 3 months post treatment were evaluated. Solid-phase ELISA (enzyme-linked immunosorbent assay) was performed for assessment of Gd-IgA1 level. All renal biopsies were scored by using Oxford Classification (C-MEST score). The association of serum Gd-IgA1 levels with other established prognostic parameters was assessed. To estimate the prognostic value of markers, logistic regression analysis and Kruskal-Wallis ANOVA (analysis of variance) were used.

Results.—: Significant difference was observed in the serum Gd-IgA1 level values in the IgA nephropathy cases and healthy controls (P = .001) at baseline. However, no significant correlation between serum Gd-IgA1 levels at baseline and 3 months of follow-up (P = .31) or between baseline levels and age, proteinuria, hematuria, or estimated glomerular filtration rate was noted. There was no significant correlation between C-MEST score and serum Gd-IgA1 levels at baseline (P > .05); however, the distribution of Gd-IgA1 at 3 months was found to differ significantly between different grades of S score (P = .008).

Conclusions.—: Serum Gd-IgA1 levels may be of utility in predicting disease progression in IgA nephropathy cases. Measurement of serum Gd-IgA1 levels for the diagnosis and prognosis of IgA nephropathy may preclude the need for invasive renal biopsies.