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Novel quantitative method to evaluate globotriaosylceramide inclusions in renal peritubular capillaries by virtual microscopy in patients with fabry disease.

Abstract

CONTEXT
Assessing the amount of globotriaosylceramide inclusions in renal peritubular capillaries by a semiquantitative approach is a standard and useful measure of therapeutic efficacy in Fabry disease, achievable by light microscopy analysis.
OBJECTIVE
To describe a novel virtual microscopy quantitative method to measure globotriaosylceramide inclusions (Barisoni Lipid Inclusion Scoring System [BLISS]) in renal biopsies from patients with Fabry disease.
DESIGN
Plastic embedded 1-µm-thick sections from kidney biopsies from 17 patients enrolled in a Fabry disease clinical trial were evaluated using a standard semiquantitative methodology and BLISS to compare sensitivity. We also tested intrareader and interreader variability of BLISS and compared results from conventional light microscopy analysis with a virtual microscopy-based methodology. Peritubular capillaries were first annotated on digital images of whole slides by 1 pathologist and then scored for globotriaosylceramide inclusions by 2 additional pathologists.
RESULTS
We demonstrated that (1) quantitative analysis by BLISS results in detection of small amount of globotriaosylceramide inclusions even when by semiquantitative analysis the score is 0, (2) application of BLISS combined with conventional light microscopy results in low intrareader and interreader variability, and (3) BLISS combined with virtual microscopy results in significant reduction of intrareader and interreader variability compared with BLISS-light microscopy.
CONCLUSIONS
BLISS is a simpler and more sensitive scoring system compared to the semiquantitative approach. The virtual microscopy-based methodology increases accuracy and reproducibility; moreover, it provides a permanent record of retrievable data with full transparency in clinical trials.

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    • Authors

    Barisoni L, Jennette JC, Colvin R, Sitaraman S, Bragat A, Castelli J, Walker D, Boudes P

    Institution

    Department of Pathology and Medicine, New York University Langone Medical Center, New York, USA. barisl01@med.nyu.edu

    Source

    Archives of pathology & laboratory medicine 136:7 2012 Jul pg 816-24

    MeSH

    Capillaries
    Fabry Disease
    Female
    Humans
    Kidney
    Male
    Microscopy
    Trihexosylceramides

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22742555