{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:22:29Z","timestamp":1790266949303,"version":"4.1.0"},"reference-count":21,"publisher":"The Korean Society of Pathologists and The Korean Society for Cytopathology","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Korean Society of Pathologist","award":["KSPG2023-01"],"award-info":[{"award-number":["KSPG2023-01"]}]}],"content-domain":{"domain":["jpatholtm.org"],"crossmark-restriction":true},"short-container-title":["J Pathol Transl Med"],"published-print":{"date-parts":[[2026,1,15]]},"abstract":"<jats:p>Background: Galactose-deficient IgA1 (Gd-IgA1) plays a crucial role in IgA nephropathy (IgAN). The monoclonal antibody KM55 has emerged as a simplified method for detecting Gd-IgA1; however, the clinicopathological significance of immunohistochemistry for Gd-IgA1 remains underexplored. This study evaluated the prognostic and clinicopathological significance of KM55 immunohistochemistry in IgAN. Methods: A total of 114 native kidney biopsies showing at least mild mesangial IgA positivity on immunofluorescence were retrospectively analyzed. Patients were categorized as having IgAN or non-IgAN diseases. The KM55 immunohistochemical staining was graded as 0, 1+, 2+, 3, or 4+. Data on Oxford classification, laboratory parameters, and renal outcomes were collected. Results: The IgAN group showed significantly higher KM55 scores than the non-IgAN group (median: 3 vs. 1; p &lt; .001). IgAN cases were further stratified into KM55-high (\u22653+, n = 38) and -low groups (\u22642+, n = 37). The KM55-high group had significantly higher diastolic blood pressure, blood urea nitrogen, creatinine, urine protein\/creatinine ratio, and Oxford mesangial hypercellularity scores, along with lower estimated glomerular filtration rate (eGFR) and serum albumin. Cox analysis revealed significantly poorer outcomes in the KM55-high group for chronic kidney disease stage 4 (p = .015), end-stage renal disease (p = .024), and 75% eGFR decline (p = .016). Conclusions: Mesangial Gd-IgA1 deposition graded by KM55 immunohistochemistry may be a useful adjunct for IgAN diagnosis and a potential prognostic biomarker.<\/jats:p>","DOI":"10.4132\/jptm.2025.09.17","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T07:09:26Z","timestamp":1768374566000},"page":"69-82","update-policy":"https:\/\/doi.org\/10.4132\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Significance of KM55 immunohistochemical staining in the diagnosis and prognosis of IgA nephropathy"],"prefix":"10.4132","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3087-2479","authenticated-orcid":true,"given":"Hoe In","family":"Jeong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2856-0133","authenticated-orcid":true,"given":"Beom 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