{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:56:06Z","timestamp":1793055366851,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","funder":[{"name":"European Union - Next Generation EU","award":["MR1-2022-12375953"],"award-info":[{"award-number":["MR1-2022-12375953"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Anti\u2013slit autoantibody profiles identified different podocytopathy phenotypes, with anti-podocin\/KIRREL1 associated with FSGS and steroid resistance.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Anti-nephrin, anti-podocin, and anti-KIRREL1 testing improved risk stratification, identifying patients at a risk of CKD and post-transplant recurrence.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti-nephrin, anti-podocin, and anti-KIRREL1 antibodies are increasingly recognized as causes of autoimmune podocytopathies, yet autoantibody-specific clinical phenotypes remain poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a multicenter study integrating serology and super-resolution microscopy in 471 samples, including 213 cases with 146 kidney biopsies (minimal change\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =63, FSGS\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =83), and sera from 128 patients (minimal changes\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =30, FSGS\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =42, idiopathic nephrotic syndrome or isolated proteinuria\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =56), including 61 paired specimens plus 258 controls (75 kidney biopsies, 200 sera, including 17 paired specimens). Paired specimens were used to assess ELISA performance by comparing serum results with IgG colocalization of target proteins within the filtration slit using receiver operating characteristic curves. All assays showed high specificity but lower sensitivity than super-resolution microscopy. Clinical features and long-term outcomes associated with individual autoantibodies and their combinations were also evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Anti\u2013slit diaphragm antibodies were detected in 67\/213 patients: 63% had anti-nephrin, 9% anti-podocin, or 3% anti-KIRREL1 antibodies only, while 25% had multiple autoantibodies. Isolated anti-nephrin antibodies were associated with minimal changes (91%), steroid sensitivity (88%), and absence of CKD over 120 months. In contrast, anti-podocin and\/or anti-KIRREL1 antibodies correlated with FSGS (84%), steroid resistance (58%), CKD progression (36%), and kidney failure (24%). Among 26 transplant recipients with FSGS, early post-transplant recurrence occurred in 83% of autoantibodies carriers and in 5% of the others. Recurrent patients showed anti-podocin\/KIRREL1 antibodies, with or without anti-nephrin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that anti-podocin and anti-KIRREL1 antibodies associate with steroid resistance, FSGS, and disease recurrence after transplantation in autoimmune podocytopathies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.0000001195","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:02:26Z","timestamp":1784822546000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Anti-podocin and Anti-KIRREL1 Antibodies and Steroid Resistance, FSGS, and Disease Recurrence after Transplantation in Autoimmune Podocytopathies"],"prefix":"10.1681","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-3251","authenticated-orcid":false,"given":"Valentina","family":"Raglianti","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy"},{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3988-7852","authenticated-orcid":false,"given":"Maria Lucia","family":"Angelotti","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0440-7356","authenticated-orcid":false,"given":"Luigi","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy"},{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1011-7291","authenticated-orcid":false,"given":"Francesca","family":"Becherucci","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy"},{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8548-2031","authenticated-orcid":false,"given":"Letizia","family":"De Chiara","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-5622","authenticated-orcid":false,"given":"Benedetta","family":"Mazzinghi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2107-7249","authenticated-orcid":false,"given":"Antea","family":"Di Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3573-9254","authenticated-orcid":false,"given":"Giulia","family":"Salvatore","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2555-2130","authenticated-orcid":false,"given":"Giulia","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7679-2935","authenticated-orcid":false,"given":"Carolina","family":"Conte","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4599-4083","authenticated-orcid":false,"given":"Maria Elena","family":"Melica","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8336-1634","authenticated-orcid":false,"given":"Paula","family":"Diaz-Bulnes","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Gnagni","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8534-9441","authenticated-orcid":false,"given":"Luca","family":"Malatesta","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences Mario Serio, University of Florence, Florence, 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Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1388-8558","authenticated-orcid":false,"given":"Josep Maria","family":"Cruzado","sequence":"additional","affiliation":[{"name":"Nephrology Department, Renal Transplant Unit, Bellvitge University Hospital, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3773-9744","authenticated-orcid":false,"given":"Domenico","family":"Giannese","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4772-7787","authenticated-orcid":false,"given":"Chiara","family":"Somma","sequence":"additional","affiliation":[{"name":"Nephrology Unit Florence 1, Santa Maria Annunziata Hospital, Bagno a Ripoli, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3100-0566","authenticated-orcid":false,"given":"Tommaso","family":"Mazzierli","sequence":"additional","affiliation":[{"name":"Nephrology Unit Florence 1, Santa Maria Annunziata Hospital, Bagno a Ripoli, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8898-3459","authenticated-orcid":false,"given":"Baerbel","family":"Lange-Sperandio","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6107-9611","authenticated-orcid":false,"given":"Federica","family":"Baccini","sequence":"additional","affiliation":[{"name":"Department of Computer, Control and Management Engineering \u201cAntonio Ruberti\u201d 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