B-Cell Dysregulation in Idiopathic Nephrotic Syndrome: What We Know and What We Need to Discover

Abstract

The therapeutic efficacy of B-cell depletion by anti-CD20 treatment in pediatric and, more recently, in adult idiopathic nephrotic syndrome patients suggests a key role of B cells in the pathogenesis of the disease. However, their exact role is still unclear. B cells are able to secrete a large variety of antibodies that can protect against infections. However, B-cell dysregulation is well-established in a variety of autoimmune diseases. In parallel with their ability to produce antibodies, pathogenic B cells display altered effector functions by expressing activating surface molecules, which can strongly modify the immune homeostasis, or by producing specific cytokines, which can directly affect either podocyte structure and functions or modulate T-cell homeostasis. Herein, we report the most relevant clinical and experimental evidences of a pathogenic role of B cells in idiopathic nephrotic syndrome. We further highlight similarities and differences between children and adults affected by non-genetic forms of the disease and discuss what needs to be investigated in order to define the exact mechanisms underlying the pathogenic role of B cells and to identify more tailored therapeutic approaches.

Association between proteinuria trajectories and outcomes in critically ill patients with sepsis or shock

“…The cancer could promote the production of these circulating factors. The lymphocytes widely involved in the pathophysiology of minimal change disease [ 29 ] and in the modulation of immune response in sepsis [ 30 ] and cancer [ 31 ] could be a keystone in the mechanism of our findings.…”

Assessment of antibody responses against SARS-CoV-2 in unvaccinated individuals and vaccinees from Omicron-BA.2 infection in Zhaoqing, Guangdong Province, China

“…Interestingly, in this study, the levels of humoral immunity against Omicron-specific IgM were significantly increased after breakthrough infection, suggesting that the detection of Omicron-specific IgM antibodies can be used as a test criterion of Omicron breakthrough infection. As we know, IgM antibodies are produced at a very early stage of infection, then the antibody isotype switch from IgM to IgG usually occurs with the progression of the humoral immune response development [ 7 ]. Therefore, IgM antibodies are generated in the early stages of infection, then IgG is a signal for the latter stages of infection.…”

Assessment of antibody responses against SARS-CoV-2 in unvaccinated individuals and vaccinees from Omicron-BA.2 infection in Zhaoqing, Guangdong Province, China

“…Interestingly, in this study, the levels of humoral immunity against Omicron speci c IgM were signi cantly increased after breakthrough infection, suggesting that the detection of Omicron speci c IgM antibodies can be used as a test criterion of Omicron breakthrough infection. As we know, IgM antibodies are produced at a very early stage of infection, then the antibody isotype switch from IgM to IgG usually occurs with the progression of the humoral immune response development 7 . Therefore, IgM antibodies are generated in the early stages of infection, then IgG is a signal for the latter stages of infection.…”