Successful treatment of patients with lipoprotein glomerulopathy by protein A immunoadsorption: a pilot study
Abstract
Background No established therapy is available for patients with lipoprotein glomerulopathy (LPG). Protein A immunoadsorption has been proved to be effective in reducing proteinuria in patients with nephrotic syndrome. In this uncontrolled pilot study, we investigated the efficiency of immunoadsorption onto staphylococcal protein A as treatment for LPG. Methods Thirteen patients with renal biopsy-proven LPG were treated with staphylococcal protein A immunoadsorption. Immunoadsorption was administered for 10 cycles per session and 10 sessions as a course. A total of 30 l of plasma was regenerated in each course. Results Single immunoadsorption course led to a rapid decline in proteinuria from 4.01 +/- 3.09 g/24 h to 1.21 +/- 0.97 g/24 h (mean +/- SD) (n = 13, P = 0.001), along with a dramatic decline in apolipoprotein E (apo E) from 9.79 +/- 5.04 mg/dl to 6.20 +/- 2.22 mg/dl (P = 0.004). A repeated renal biopsy (n = 12) showed that intraglomerular lipoprotein thrombi almost disappeared. Six patients were enrolled in the investigation of long-term outcome, and proteinuria returned to baseline levels within 12 months. Four recurrent patients received repeat immunoadsorption treatment; proteinuria decreased from 5.02 +/- 1.85 g/24 h to 1.64 +/- 0.55 g/24 h at the end of the treatment, serum apo E decreased from 14.65 +/- 11.17 mg/dl to 7.90 +/- 1.72 mg/dl. No patients suffered from severe complications. Conclusion Our observations suggest that immunoadsorption onto protein A migh…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Most LPG patients have been reported to present elevated plasma apoE levels, while normalization or reduction of apoE levels following various treatments results in remission or improvement of the disease.
“Most of the LPG patients have been reported to present elevated plasma apoE levels (5, 6, 23-25), while it has been observed that normalization or reduction of apoE levels following various treatments (e.g., lipid-lowering treatments with fenofibrate or protein A immunoadsorption) result in remission or improvement of the disease (24,25,47).”
From Thermodynamic destabilization and aggregation propensity as the mechanism behind the association of apoE3 mutants and lipoprotein glomerulopathy (2018) · cites this paper as [25]
Additional treatments including renin-angiotensin-aldosterone system inhibitors and plasma adsorption/exchange therapy have been proven effective in LPG monitoring.
“Additional treatments include renin-angiotensin-aldosterone system inhibitors and plasma adsorption/exchange therapy have also been proven to be effective in LPG monitoring [21, 22].”
From A case report of youth-onset lipoprotein glomerulopathy with APOE Chicago mutation (2024) · cites this paper as [22]
Worldwide, only 22 cases of LPG including this case have reported the results of more than one native kidney biopsy.
“Worldwide, only 22 cases of LPG including this case have reported the results of more than one native kidney biopsy.14,15,29,32,44–49”
From Lipoprotein Glomerulopathy, First Case Report from Canada (2022) · cites this paper as [48]
A study in China demonstrated the feasibility of staphylococcal protein A immunoadsorption therapy, because staphylococcal protein A can bind to the Fc of IgG, thereby clearing circulating ApoE and deposited ApoE in renal tissues, and regular treatment can significantly delay the progression of renal disease.
“A study in China demonstrated the feasibility of staphylococcal protein A immunoadsorption therapy,[36] because staphylococcal protein A can bind to the Fc of IgG, thereby clearing circulating ApoE and deposited ApoE in renal tissues,[37] and regular treatment can significantly delay the progression of renal disease.”
From A boy and his mother with lipoprotein glomerulopathy: Two case reports and literature review (2025) · cites this paper as [36]
Cites
Lipoprotein Glomerulopathy: Glomerular Lipoprotein Thrombi in a Patient With Hyperlipoproteinemia
Saito, T., Sato, H., Kudo, K.-I., Oikawa, S.-I., Shibata, T., Hara, Y., Yoshinaga, K., & Sakaguchi, H. (1989) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(89)80134-9 · Cited by 148 · see citing works
Arai, T., Yamashita, S., Yamane, M., Manabe, N., Matsuzaki, T., Kiriyama, K., Kanayama, Y., Himeno, S., & Matsuzawa, Y. (2003) · Atherosclerosis · doi:10.1016/s0021-9150(03)00194-1 · Cited by 43 · see citing works
Clinicopathological and genetic characteristics in Chinese patients with lipoprotein glomerulopathy
Zhang, B., Liu, Z.-H., Zeng, C.-H., Zheng, J.-M., Chen, H.-P., & Li, L.-S. (2008) · Journal of Nephrology · doi:10.1093/joneph/21.1.110 · Cited by 12 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Apolipoprotein E–related glomerular disorders
Saito, T., Matsunaga, A., Fukunaga, M., Nagahama, K., Hara, S., & Muso, E. (2020) · Kidney International · doi:10.1016/j.kint.2019.10.031 · Cited by 77 · see citing works
Tsimihodimos, V., & Elisaf, M. (2011) · Current Opinion in Lipidology · doi:10.1097/mol.0b013e328345ebb0 · Cited by 33 · see citing works
Katsarou, M., Stratikos, E., & Chroni, A. (2018) · Journal of Lipid Research · doi:10.1194/jlr.m088732 · Cited by 22 · see citing works
Lipoprotein Glomerulopathy, First Case Report from Canada
Ting, J. A., McRae, S. A., Schwartz, D., Barbour, S. J., & Riazy, M. (2022) · International Journal of Nephrology and Renovascular Disease · doi:10.2147/ijnrd.s364890 · Cited by 7 · see citing works
A case report of youth-onset lipoprotein glomerulopathy with APOE Chicago mutation
Liu, Y., Cheng, Y., Wen, Y., Li, C., Chen, G., & Li, M. (2024) · BMC Nephrology · doi:10.1186/s12882-024-03515-z · Cited by 2 · see citing works
A boy and his mother with lipoprotein glomerulopathy: Two case reports and literature review
Zhang, S., Fan, L., Li, Z., Liu, T., Jing, X., & Guo, Q. (2025) · Medicine · doi:10.1097/md.0000000000041628 · Cited by 2 · see citing works
- Authors
- Xin, Z., Zhihong, L., Shijun, L., Jinfeng, Z., Huiping, C., Caihong, Z., Daxi, J., & Leishi, L.
- Affiliations
- Nanjing General Hospital of Nanjing Military Command (CN)
- Corresponding author
- Xin, Z.
- Venue
- Nephrology Dialysis Transplantation
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-10-08
- Volume
- 24
- Issue
- 3
- Pages
- 864-869
- ISSN
- 0931-0509 (ISSN-L)
- 1460-2385
- OpenAlex
- W2147537511
- Cited by
- 27
- References
- 3
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2022: 2 · 2021: 1 · 2019: 3 · 2018: 3 · 2016: 2 · 2014: 2 · 2013: 6 · 2012: 1
- FWCI
- 0.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nephrology Dialysis Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Renal Diseases and Glomerulopathies
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Keywords
- lipoprotein glomerulopathy, protein A immunoadsorption, proteinuria, apolipoprotein E, nephrotic syndrome, plasma exchange
- MeSH terms
- Adolescent, Adult, Apolipoproteins E, Female, Follow-Up Studies, Humans, Kidney Tubules, Male, Middle Aged, Nephrotic Syndrome, Pilot Projects, Plasmapheresis, Proteinuria, Staphylococcal Protein A, Time Factors, Treatment Outcome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
