Renal hypoplasia can be the cause of membranous nephropathy-like lesions
CLINICAL AND EXPERIMENTAL NEPHROLOGY
Authors: Takizawa, Keiichi; Miura, Kenichiro; Kaneko, Naoto; Yabuuchi, Tomoo; Ishizuka, Kiyonobu; Kanda, Shoichiro; Harita, Yutaka; Akioka, Yuko; Horita, Shigeru; Taneda, Sekiko; Honda, Kazuho; Hattori, Motoshi
Abstract
Background Renal hypoplasia (RH) is the most common cause of chronic kidney disease in children. In cases of RH, proteinuria is often induced by glomerular hypertrophy and hyperfiltration that is commonly associated with focal segmental glomerulosclerosis. This study reports the first case series of a possible association between RH and membranous nephropathy (MN). Methods Of the 168 children with RH who visited our department between 1999 and 2017, five with overt proteinuria (>= 1 g/gCr) underwent renal biopsy. We retrospectively reviewed the medical charts and analyzed biopsy specimens using light microscopy (LM), immunofluorescence (IF), and electron microscopy. Results The five children (four boys and one girl) had a median age of 5.5 years at the time of renal biopsy. The median proteinuria was 4.23 g/gCr (range 1.46-14.25), median serum albumin, 2.9 g/dL (range 2.3-3.7), and median estimated glomerular filtration rate, 59.7 mL/min/1.73 m(2) (range 36.7-103.6). LM showed segmental spike formation and mesangial hypercellularity and IF study showed segmental granular immunoglobulin G (IgG) staining (IgG1 and IgG3 dominant) along the capillary loops in all five patients. Electron-dense deposits were observed in the subepithelial and mesangial areas. Thus, the pathological studies showed MN-like lesions in all patients. Conclusion Our study suggests that RH can be the cause of MN-like lesions.
Modulating antibody-dependent cellular cytotoxicity of epidermal growth factor receptor-specific heavy-chain antibodies through hinge engineering
IMMUNOLOGY AND CELL BIOLOGY
Authors: D'Eall, Calvin; Pon, Robert A.; Rossotti, Martin A.; Krahn, Natalie; Spearman, Maureen; Callaghan, Deborah; van Faassen, Henk; Hussack, Greg; Stetefeld, Jorg; Butler, Michael; Durocher, Yves; Zhang, Jianbing; Henry, Kevin A.; Tanha, Jamshid
Abstract
Human IgG1 and IgG3 antibodies (Abs) can mediate Ab-dependent cellular cytotoxicity (ADCC), and engineering of the Ab Fc (point mutation; defucosylation) has been shown to affect ADCC by modulating affinity for FcR gamma IIIa. In the absence of a C(H)1 domain, many camelid heavy-chain Abs (HCAbs) naturally bear very long and flexible hinge regions connecting their VHH and C(H)2 domains. To better understand the influence of hinge length and structure on HCAb ADCC, we produced a series of hinge-engineered epidermal growth factor receptor (EGFR)-specific chimeric camelid VHH-human Fc Abs and characterized their affinities for recombinant EGFR and FcR gamma IIIa, their binding to EGFR-positive tumor cells, and their ability to elicit ADCC. In the case of one chimeric HCAb (EG2-hFc), we found that variants bearing longer hinges (IgG3 or camelid hinge regions) showed dramatically improved ADCC in comparison with a variant bearing the human IgG1 hinge, in similar fashion to a variant with reduced C(H)2 fucosylation. Conversely, an EG2-hFc variant bearing a truncated human IgG1 upper hinge region failed to elicit ADCC. However, there was no consistent association between hinge length and ADCC for four similarly engineered chimeric HCAbs directed against distinct EGFR epitopes. These findings demonstrate that the ADCC of some HCAbs can be modulated simply by varying the length of the Ab hinge. Although this effect appears to be heavily epitope-dependent, this strategy may be useful to consider during the design of VHH-based therapeutic Abs for cancer.