Professor Mark Little

Institution: Trinity Health Kidney Centre, Nephrology, Renal Inflammation Group, St. James Hospital, Dublin, Ireland
Title: Rational treatment of glomerulonephritis using a novel urine biomarker
Award: $49,294, one-year

This project is focused on development of a new biomarker test in the diagnosis and monitoring of crescentic glomerulonephritis (CGN), a severe form of inflammatory kidney injury. This test relies upon identification of a single protein in the urine: soluble CD163. This is shed from activated white blood cells within the kidney, which are in direct communication with the urine. We have discovered that the level rises when kidney vasculitis is active, and is not elevated in other causes of kidney disease. Therefore, it is highly specific for CGN.

We aim to track urinary sCD163 during the first few months of treatment for CGN to investigate its usefulness as a biomarker to help us decide when to switch to less intensive maintenance treatment. This will be achieved by engagement with three clinical research facilities in the Dublin area and the recruitment of 40 patients, who will be sampled 7-12 times over the year following commencement of therapy.

Most current biomarker programmes rely upon panels of compounds. We have discovered a single protein that closely mirrors CGN, which has the potential to provide a guide for clinicians as to when to discontinue potentially toxic induction therapy. The current project will bring this closer to a point of care test that will improve the care of patients with vasculitic disorders.