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nephritis-associated plasmin receptor

Yohei Komaru, Kunihiro Ishioka, Takashi Oda, Takayasu Ohtake, Shuzo Kobayashi
Infection-related glomerulonephritis (IRGN) develops after various infections. It was previously thought to be caused by Streptococcus species alone but can also be caused by other pathogens. Nephritis-associated plasmin receptor (NAPlr) was discovered as a candidate nephritis-inducing factor in acute post-streptococcal glomerulonephritis. More recently, renal lesions caused by other pathogens were found to be positive for the same molecular marker. We report the case of a 64-year-old man who experienced repeated fever for several months and presented with progressively-deteriorating renal function...
March 26, 2018: Clinical Nephrology
Ramnath Balasubramanian, Stephen D Marks
Post-infectious glomerulonephritis (PIGN) is one of the most common causes of acute glomerulonephritis in children. Although post-streptococcal glomerulonephritis (PSGN) is still common, there is a wide spectrum of causative agents of PIGN. Non-streptococcal organisms are emerging as the main aetiological agents in high-income countries. Nephritis-associated plasmin receptor (NAPlr) and streptococcal pyrogenic exotoxin B (SPeB) are the two common antigens implicated in the pathogenesis of PSGN. Both NAPlr and SPeB activate the alternative complement pathway, resulting in low serum complement levels, and have an affinity to plasmin and glomerular proteins...
November 2017: Paediatrics and International Child Health
Eriko Takehara, Shintaro Mandai, Satomi Shikuma, Wataru Akita, Motoko Chiga, Takayasu Mori, Takashi Oda, Michio Kuwahara, Shinichi Uchida
A 55-year-old man developed rapidly progressive glomerulonephritis and nephrotic syndrome. A kidney biopsy specimen showed diffuse proliferative and crescentic glomerulonephritis with monoclonal IgG1κ, humps, and nephritis-associated plasmin receptor, indicating infection-associated proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID). Despite dialysis-dependent renal failure, symptomatic therapy resulted in spontaneous recovery of the renal function, mimicking post-infectious glomerulonephritis (PIGN)...
2017: Internal Medicine
Ken Iseri, Masayuki Iyoda, Yasutaka Yamamoto, Naoto Kobayashi, Takashi Oda, Yutaka Yamaguchi, Takanori Shibata
We herein report the case of an 18-year-old boy who developed nephrotic syndrome and hypertension after upper airway inflammation. Post-streptococcal acute glomerulonephritis was diagnosed on the basis of a high antistreptolysin O titer, hypocomplementemia, proteinuria, and microscopic hematuria. A renal biopsy was performed due to persistent proteinuria, and the pathological diagnosis was membranoproliferative glomerulonephritis (MPGN) type I. Glomeruli showed positive staining for nephritis-associated plasmin receptor (NAPlr), a nephritogenic group A streptococcal antigen, and plasmin activity was found in a similar distribution as NAPlr deposition...
2016: Internal Medicine
Ayako Kokuzawa, Yoshiyuki Morishita, Hiromichi Yoshizawa, Kana Iwazu, Takanori Komada, Tetsu Akimoto, Osamu Saito, Takashi Oda, Fumi Takemoto, Yasuhiro Ando, Shigeaki Muto, Wako Yumura, Eiji Kusano
We herein report the case of a 17-year-old man who developed an increased plasma creatinine level (11.1 mg/dL) and oliguria with massive proteinuria (27.3 g/day) four weeks after an abraded wound to his right knee. The histology of the renal biopsy specimens showed diffuse endocapillary proliferative glomerulonephritis with the deposition of nephritis-associated plasmin receptor in the glomerulus. A case of acute kidney injury due to nephrotic syndrome caused by acute post-streptococcal glomerulonephritis was diagnosed...
2013: Internal Medicine
Takashi Oda, Nobuyuki Yoshizawa, Kazuo Yamakami, Yutaka Sakurai, Hanako Takechi, Kojiro Yamamoto, Naoki Oshima, Hiroo Kumagai
It is well known that glomerulonephritis can occur after streptococcal infection, which is classically referred to as acute poststreptococcal glomerulonephritis (APSGN). The pathogenic mechanism of APSGN has been described by so-called immune complex theory, which involves glomerular deposition of nephritogenic streptococcal antigen and subsequent formation of immune complexes in situ and/or the deposition of circulating antigen-antibody complexes. However, the exact entity of the causative antigen has remained a matter of debate...
2012: Journal of Biomedicine & Biotechnology
Neeraja Kambham
Postinfectious glomerulonephritis (PIGN) is an immunologically mediated glomerular injury triggered by an infection. Poststreptococcal glomerulonephritis (PSGN) is a classic example of PIGN with diffuse proliferative and exudative glomerular histology, dominant C3 staining and subepithelial "humps." Only the nephritogenic streptococcal infections cause PSGN and susceptibility to develop PSGN depends on both host and microbial factors. Over the last decade, two nephritogenic antigens, "nephritis-associated plasmin receptor" and "streptococcal pyrogenic exotoxin B" have been identified...
September 2012: Advances in Anatomic Pathology
Masahiro Okabe, Nobuo Tsuboi, Takashi Yokoo, Yoichi Miyazaki, Yasunori Utsunomiya, Tatsuo Hosoya
The differential diagnosis of acute poststreptococcal glomerulonephritis (APSGN) and idiopathic membranoproliferative glomerulonephritis (MPGN) is sometimes difficult, as they share several key features in their laboratory and histological findings, especially during the acute phase of the diseases. We herein report an idiopathic case of MPGN in which the glomerular deposition of nephritis-associated plasmin receptor (NAPlr), a recently identified nephritic antigen for APSGN, was demonstrated. A 24-year-old postpartum woman developed nephrotic syndrome and hypocomplementemia...
April 2012: Clinical and Experimental Nephrology
Takahiro Uchida, Takashi Oda, Atsushi Watanabe, Tomoko Izumi, Keishi Higashi, Taketoshi Kushiyama, Soichiro Miura, Hiroo Kumagai
A 16-year-old male adolescent who had fallen and scratched his knee developed cold-like symptoms. Gross hematuria, oliguria, and peripheral edema appeared about 2 weeks after his fall. Tests showed hypocomplementemia, increased antistreptolysin O titers, and severe kidney failure with hematuria/proteinuria. Kidney biopsy showed endocapillary proliferative glomerulonephritis visible using light microscopy and deposits of complement C3 on capillary walls, detectable using immunofluorescence microscopy. Although these findings suggested that he had acute poststreptococcal glomerulonephritis (APSGN), electron microscopy failed to detect subepithelial humps, a feature typical of APSGN; instead, massive electron-dense deposits were visible in the subendothelial space...
July 2011: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Takashi Oda, Nobuyuki Yoshizawa, Kazuo Yamakami, Kikuko Tamura, Aki Kuroki, Tetsuzo Sugisaki, Emi Sawanobori, Kohsuke Higashida, Yoshiyuki Ohtomo, Osamu Hotta, Hiroo Kumagai, Soichiro Miura
The nephritis-associated plasmin receptor is a recently identified nephritogenic antigen associated with acute poststreptococcal glomerulonephritis and proposed to play a pathogenic role, but its precise glomerular localization in acute poststreptococcal glomerulonephritis has not been elucidated. We therefore analyzed renal biopsy sections from 10 acute poststreptococcal glomerulonephritis patients by using immunofluorescence staining with anti-nephritis-associated plasmin receptor antibody and various markers of glomerular components...
September 2010: Human Pathology
Kenichi Suga, Shuji Kondo, Sato Matsuura, Yukiko Kinoshita, Etsuko Kitano, Michiyo Hatanaka, Hajime Kitamura, Yoshihiko Hidaka, Takashi Oda, Shoji Kagami
A 14-year-old girl presented with acute glomerulonephritis. Tests revealed hypocomplementemia and elevated Antistreptolysin-O titers, and renal biopsy revealed endocapillary and mesangial proliferative glomerulonephritis with double contours of the glomerular basement membrane (GBM). Despite methylprednisolone pulse therapy and the administration of oral prednisolone, overt proteinuria and hypocomplementemia persisted. A second renal biopsy 6 months later confirmed the initial diagnosis of dense deposit disease (DDD) based on electron-dense deposits in the GBM...
August 2010: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
E Sawanobori, A Umino, H Kanai, K Matsushita, S Iwasa, H Kitamura, T Oda, N Yoshizawa, K Sugita, K Higashida
We herein report the case of a 12-year-old boy with dense deposit disease (DDD) evoked by streptococcal infection. He had been diagnosed to have asymptomatic hematuria syndrome at the age of 6 during school screening. At 12 years of age, he was found to have macrohematuria and overt proteinuria with hypocomplementemia 2 months after streptococcal pharyngitis. Renal biopsy showed endocapillary proliferative glomerulonephritis with double contours of the glomerular basement membrane. Hypocomplementemia and proteinuria were sustained for over 8 weeks...
June 2009: Clinical Nephrology
Sun-Young Ahn, Elizabeth Ingulli
PURPOSE OF REVIEW: Acute poststreptococcal glomerulonephritis, the most common form of acute glomerulonephritis in children, continues to be a major concern worldwide. This review summarizes the recent advances in the pathogenesis, host susceptibility factors, diverse clinical presentations, and treatment of the condition. RECENT FINDINGS: Several recent advances have been made in identifying streptococcal antigens that may play a pathogenic role in acute poststreptococcal glomerulonephritis...
April 2008: Current Opinion in Pediatrics
Takashi Oda, Kikuko Tamura, Nobuyuki Yoshizawa, Tetsuzo Sugisaki, Koichi Matsumoto, Motoshi Hattori, Toshihiro Sawai, Tamehachi Namikoshi, Muneharu Yamada, Yuichi Kikuchi, Shigenobu Suzuki, Soichiro Miura
BACKGROUND: A pathogenic role of intraglomerular plasmin bound to nephritogenic antigen (nephritis-associated plasmin receptor, NAPlr) and resistant to physiologic inhibitors such as alpha(2)-antiplasmin (alpha(2)-AP) has recently been proposed in acute poststreptococcal glomerulonephritis (APSGN). To confirm this concept, we analysed the urinary profile of plasmin cascade in APSGN patients. METHODS: Urine samples from 10 patients with APSGN, 12 patients with IgA nephropathy (IgAN), 10 patients with streptococcal infection without nephritis (SI) and 10 healthy control subjects were analysed...
July 2008: Nephrology, Dialysis, Transplantation
Masayuki Fujino, Kazuo Yamakami, Takashi Oda, Fumihiro Omasu, Teiko Murai, Nobuyuki Yoshizawa
BACKGROUND: The relation of nephritis-associated plasmin receptor (NAPlr) as a nephritogenic antigen in group A streptococci (GAS), to acute poststreptococcal glomerulonephritis (APSGN) and the potential of specific strains to cause APSGN are not fully understood. It would be helpful to determine whether certain GAS strains from APSGN patients specifically express NAPlr and whether strains from non-APSGN patients express lower levels or an altered form of NAPlr. METHODS: The sequence and levels of expression of NAPlr were assayed for strains of GAS isolated from patients with APSGN, pharyngitis, scarlet fever or toxic shock-like syndrome...
May 2007: Journal of Nephrology
Y Kikuchi, N Yoshizawa, T Oda, T Imakiire, S Suzuki, S Miura
We report the case of a 25-year-old man with abdominal pain, purpura on the legs and proteinuria occurring 2 weeks after acute tonsillitis, and admitted to our hospital with suspected Henoch-Schönlein purpura nephritis (HSPN). He had increased anti-streptolysin O (ASO) titer and hypocomplementemia. A renal biopsy specimen showed endocapillary proliferative changes, which are typical of acute poststreptococcal glomerulonephritis (APSGN). However, immunofluorescence study revealed predominant IgA and C3 deposits in mesangial lesions, indicating a diagnosis of HSPN...
February 2006: Clinical Nephrology
Takashi Oda, Kazuo Yamakami, Fumihiro Omasu, Shigenobu Suzuki, Soichiro Miura, Tetsuzo Sugisaki, Nobuyuki Yoshizawa
A nephritogenic antigen for acute poststreptococcal glomerulonephritis (APSGN) was isolated recently from group A streptococcus and termed nephritis-associated plasmin receptor (NAPlr). In vitro experimental data indicate that the pathogenic role of NAPlr occurs through its ability to bind to plasmin and maintain its proteolytic activity. However, the mechanism whereby this antigen induces glomerular damage in vivo has not been fully elucidated. Renal biopsy tissues from 17 patients with APSGN, 8 patients with rapidly progressive glomerulonephritis, and 10 normal kidneys were analyzed in this study...
January 2005: Journal of the American Society of Nephrology: JASN
Nobuyuki Yoshizawa, Kazuo Yamakami, Masayuki Fujino, Takashi Oda, Kikuko Tamura, Koichi Matsumoto, Tetsuzo Sugisaki, Michael D P Boyle
The role of nephritis-associated antigen as a virulence factor for acute poststreptococcal glomerulonephritis (APSGN) remains to be fully clarified. Nephritis-associated plasmin receptor (NAPlr) was previously isolated from group A streptococcus (GAS) and shown to bind plasmin(ogen). The nucleotide sequence of the naplr gene from GAS isolates obtained from patients with APSGN was determined. The sequence of the putative open reading frame (1011 bp) showed 99.8% identity among isolated strains. Homology screen revealed an exact match with streptococcal glyceraldehyde-3-phosphate dehydrogenase (GAPDH)...
July 2004: Journal of the American Society of Nephrology: JASN
Miwa Masuda, Koichi Nakanishi, Nobuyuki Yoshizawa, Kazumoto Iijima, Norishige Yoshikawa
BACKGROUND: Although the pathogenesis of Henoch-Schönlein nephritis (HSN) remains unclear, there is substantial evidence that it is an immune complex-mediated disease. HSN is preceded by upper-respiratory tract infection in 30% to 50% of patients, but there is no evidence that group A streptococcal (GAS) infection has a pathogenetic role in this disease. Recently, nephritis-associated plasmin receptor (NAPlr), a GAS antigen, was found primarily in the glomerular mesangium of patients with early-stage acute poststreptococcal glomerulonephritis...
February 2003: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
T Watanabe, N Yoshizawa
Recurrence of acute poststreptococcal glomerulonephritis (APSGN) is a rare phenomenon. We present an 8-year-old boy with a second episode of APSGN 12 months following a complete clinical recovery from his initial attack. Renal histology, obtained from renal biopsies of the patient during the second attack, showed diffuse endocapillary proliferation, granular deposition of C3, IgG, IgA, and fibrinogen along capillary walls, and subepithelial electron-dense deposits. A new streptococcal cytoplasmic antigen (nephritis-associated plasmin receptor protein, NAP1r), which was recently identified as the pathogenic antigen in APSGN, was detected in the glomeruli of an early kidney biopsy specimen from the patient during the second attack of APSGN, using fluorescein isothiocyanate-labeled rabbit anti-NAP1r...
July 2001: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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