Analysis of immunohistochemical staining in renal allograft and native biopsies diagnosed as Focal and Segmental Glomerulosclerosis (FSGS)

• Grant number: 21/11616-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: May 01, 2022
• End date: April 30, 2023
• Field of knowledge: Health Sciences - Medicine - Pathological Anatomy and Clinical Pathology
• Principal Investigator: Daniela Cristina dos Santos Souza
• Grantee: Letícia Scaffi Oliveira
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Analysis of immunohistochemical staining in renal allograft and native biopsies diagnosed as Focal and Segmental Glomerulosclerosis (FSGS). Segmental and Focal Glomerulosclerosis (FSGS) is a glomerulopathy related to podocyte injury, characterized by proteinuria as the main clinical manifestation. It constitutes a group of podocytopathies whose causes are variable, from idiopathic to secondary. The term refers to an obliteration of the glomerular capillary lumen by a focal pattern sclerotic formation, affecting up to 49% of the glomeruli represented in the biopsy sample, and segmental, compromising up to 49% of the glomerular unit area. The etiological hypothesis for this podocytopathy is related to podocytopenia, inherent to congenital or acquired factors in development, hemodynamic adaptive change, damage to podocytes, and activation of the parietal epithelial cells (PECs), which line the Bowman capsule of the glomeruli. These cells express markers that have an important regenerative capacity and may be associated with the physiopathogenesis of FSGS. The diagnosis of FSGS is based on clinical and laboratory criteria and on the analysis of biopsies, examining the morphological criteria described above together with immunofluorescence. Studies have revealed the importance of immunohistochemical markers in the identification and evolution of the disease. Among the main markers, we find mature podocyte markers such as podocin, nestin, nephrin, Wilms tumor protein (WT-1), and PEC markers such as CD44, PAX2, PAX8, and CK8 protein. Given the above, this project aims to study the expression of these immunohistochemical markers, in order to establish a relationship with the histopathological diagnosis of FSGS. It is a descriptive and retrospective analysis, which intends to introduce an additional tool in the diagnostic routine of these injuries. The study will take place at Hospital das Clínicas, Faculty of Medicine of Botucatu (HCFMB/UNESP), with a clinical and morphological review of cases diagnosed with FSGS in native and transplanted kidneys, within a period of ten years.(AU)