Can urine-based markers in children with IgA vasculitis help us to understand, predict and prevent kidney damage?
Dr Louise Oni from the University of Liverpool has been awarded a Paediatric Research Project grant of £203,000 to investigate whether the levels of certain immune substances can be used to predict which children with IgA vasculitis will go on to develop kidney damage, and whether drugs targeting these immune substances could prevent this.
The problem
Immunoglobulin A (IgA) vasculitis (also known as Henoch-Schönlein Purpura) is a disease that causes the immune protein IgA to collect in small blood vessels throughout the body, causing them to become inflamed and leak blood. It is more common in children, and it can cause rashes, tummy pain, joint pain, and kidney damage. Most children go on to make a full recovery, but 1–2 in every 100 will go on to develop kidney failure.
All children diagnosed with IgA vasculitis will have their urine checked for 6 months after diagnosis to check whether their kidneys are inflamed. If children are found to have inflamed kidneys, they will have a kidney biopsy test and they will be given treatments to reduce the activity of their immune system. However, not every child will respond to the current treatments, and those who don’t are at risk of developing kidney failure.
The solution
Louise’s vision is that no child with IgA vasculitis should get chronic kidney disease and the team are working to understand the causes of kidney problems to achieve this. The team have previously found that a part of the immune system called the complement system (a group of proteins that help your immune system to fight infection) could play a role in causing the kidneys to become inflamed in patients with IgA vasculitis.
Working in partnership with others across the UK, in this study, named the SISTA study, Louise and the team will collect urine samples from 150 children and young people with IgA vasculitis seven times over a 6-month period to study what happens to urine complement levels as children either get better or go on to develop kidney problems.
“This award is a fantastic investment in the rare disease IgA vasculitis that has been neglected in the past because it is more common in children. The award will allow us to begin to understand how we can tackle the condition early with the vision to stop kidney failure. This award is important to patients with this condition and also to those with conditions that cause inflammation in the kidneys as it will give us information on the early processes involved in how the immune system may be overreacting and insulting the kidneys.”
What this means for kidney patients
This study will help us to understand whether complement proteins in urine can predict which patients with IgA vasculitis will develop kidney damage and provide new information about when the disease process starts. Louise’s work could also reveal much-needed new therapeutic targets to stop children with IgA vasculitis from developing kidney failure.
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