CD80 and suPAR in patients with minimal change disease and focal segmental glomerulosclerosis: diagnostic and pathogenic significance: Response

Excerpt

Dr. Davin challenges our proposal on the utility of using serum suPAR and urinary CD80 levels to distinguish idiopathic focal segmental glomerulosclerosis (FSGS) from minimal change disease (MCD), which we base on the results of our study recently published in Pediatric Nephrology [1]. The basis of his argument relates to his supposition that CD80 is likely to be involved in FSGS since urinary CD80 was elevated in our patient cohort compared to normal controls. As evidence in support of his point of view he also refers to a recent study by Yu et al. that showed the presence of CD80 in glomeruli in some subjects with post-transplant FSGS [2]. These authors’ observed that the latter patients had a resolution of proteinuria with CTLA4–Ig, which is a ligand for CD80 that blocks CD80-associated T-cell activation. Dr. Davin also suggests that the higher urinary CD80 levels in MCD may reflect the passage of soluble CD80 in the urine as a consequence of activation of the immune system during MCD flares. …