António Inácio

1/3 The diagnosis of TMA is challenging. It is really a pattern of injury. What is the etiopathogenesis? How do we treat? Machine Learning can help. So thrilled to share this paper, led by @LadanZand @MayoClinicNeph @MayoClinicPath

Finding the etiology of membranoproliferative glomerulonephritis sciencedirect.com/science/articl… My review of evaluation of MPGN on kidney biopsy is out. Take home messages: 1. Idiopathic/primary immune complex (IC)-MPGN is very rare. 2. Careful evaluation of IC-MPGN will invariably reveal the etiology. Always rule out monoclonal Ig. 3. Beware of entrapment of Ig in cases of C3GN, as you might label these as IC-MPGN. 4. Consider infection related GN in cases of C3GN, even if IC is sparse/absent, in the right clinical scenario.

Retrospective cohort study of US Veterans treated with ICIs revealed two ICI-myositis phenotypes, 1) ICI myositis triad syndrome (myositis, myocarditis, and myasthenia gravis), which was defined by severe acute illness with high mortality risk shortly after starting ICI, and 2) isolated ICI myositis, defined by less severe disease and less mortality AC&R doi.org/10.1002/acr.80…

Preclinical evaluation of antigen-specific B-cell depletion for phospholipase A2 receptor membranous nephropathy with chimeric autoantibody receptor T cells pubmed.ncbi.nlm.nih.gov/41177511/

Hamburg News: Study led by our Catherine Meyer-Schwesinger on autoantibody-triggered podocyte membrane budding drives autoimmune kidney disease. @HCKH_Hamburg @UKEHamburg @unihh Cell cell.com/cell/fulltext/…

Epic new cell biology paper by Prof. Dr. med Catherine Meyer-Schwesinger and team 🏆👇 Membranous nephropathy rewrites the rules of podocyte injury. Autoantibodies don’t just bind—they trigger podocytes to bud off “AIT-EVs”, vesicles packed with autoantibodies, antigens, and stress signals. Too many AIT-EVs → foot-process collapse. And the best part: they show up in urine, creating a new non-invasive window into autoimmune kidney disease. cell.com/cell/fulltext/…

A trial of pegcetacoplan, a C3 and C3b inhibitor, in patients with C3 glomerulopathy or primary immune-complex membranoproliferative glomerulonephritis showed that the drug significantly reduced proteinuria. Full VALIANT phase 3 trial results: nej.md/4pmT67G Editorial: Pegcetacoplan for Treatment of C3 Glomerulopathy and Immune-Complex MPGN nej.md/49Q0dQV

Pegcetacoplan for Treatment of C3 Glomerulopathy and Immune-Complex MPGN @LadanZand @fervenzafernan1 nejm.org/doi/full/10.10…

Dual-antigen MN - Clinical lab test of laser microdissection & mass spectrometry revealed 2 antigens in ~2.6% PLA2R negative MN - The antigens correspond to underlying disease - Further studies needed to study outcomes Dual-Antigen Membranous Nephropathy kidney-international.org/article/S0085-…

Dr. Ingelfinger presenting at the 34th MNCG dinner about AI in medicine!

👏 The 34th Annual Mayo Nephrology Collaborative Group Meeting at Kidney Week Dr. Julia Ingelfinger of Massachusetts General Hospital as our distinguished speaker 🎙️“A Field Guide to AI for Nephrologists – Cointelligence or Cooptation?” @LadanZand @fervenzafernan1

HISTORIC AND PARADIGM CHANGING: FDA approves daratumumab for high risk smoldering multiple myeloma based on the AQUILA trial— the FIRST ever treatment approved for this indication. Excellent news and thanks to @JNJInnovMed and the huge worldwide team of investigators for making it happen. @thanosdimop @SagarLonialMD @PlasmaCellPete

Daratumumab is now approved for high risk smoldering myeloma based off #AQUILA: PhIII, Dara vs Obs: - 39 cycles/3yrs of dara - mPFS 63.1% vs 40.8% at years - OS at 5yrs 93% vs 86.9% - 5.7% discontinued dara because of AEs #MedTwitter #HemeTwitter #OncTwitter #mmsm

Starting off with IgA Nephropathy at Plenary Session! ▶️ 1. The impact of new tools by @VladoPerkovic - first #ASN2025 publication @Kidney_Int! 🔥 ▶️ 2. Just published @NEJM - Dr. Richard Lafayette on the ORIGIN 3 trial: Atacicept led to remarkable results! 🤯 #GlomerularDisease

How many complement fragments are there? In our recent work @embojournal we developed a scalable workflow to profile and discover complement fragments based on N-terminomics by mass spec. We discovered a lupus-associated immunoactive C3 fragment with IL6 receptor modulation!

Solving a controversy. In 2023, a study suggested an immunologic effect of SGLT2i in #lupusnephritis. Now in @Kidney_Int, empagliflozin did NOT modify any activity parameter in mice. SGLT2i is an outstanding CKD drug, but has no immunologic effect in SLE. shorturl.at/AEDCy

Infliximab for Grade III/IV ICI Nephritis Clinical and Translational Evidence @KIReports #openaccess buff.ly/L8usZ2Y

Complement- Kidney biopsy is grossly inadequate when it comes to complement: we stain for only C3/C1q! LMD/MS can: -determine complement pathways -determine burden of complement -Activated vs entrapped complement -Assess complement regulating proteins journals.lww.com/cjasn/abstract…

Glomerular disease made simple: The location of injury➡️ dictates pattern of injury➡️points to etiology (based on immunofluorescence) ➡️ and results in a specific clinical syndrome. Study this figure carefully & you will understand the basics of GN. journals.lww.com/cjasn/abstract…