DECODE – Defining stratification of patients with C3 Glomerulopathies /Immune complex –mediated glomerular diseases for better diagnosis and tailored treatment

ERA PerMed Joint Transnational Call 2020

Primary membranoproliferative glomerulonephritis represents a heterogenous group of rare kidney disorders classified into alternative pathway complement-mediated C3 glomerulopathy (C3G) and immune-complex-mediated MPGN (IC-MPGN). These diseases are untreatable at the
moment despite a plethora of complement inhibitors developed by many companies boosted by the success of the C5 inhibitor eculizumab that was literally transformative of the natural history of patients with atypical HUS.

In the hope that the same could apply to patients with MPGN the main goal of DECODE is to improve the diagnosis and management of these very patients through precise stratification and tailored treatment protocols.
Previous studies by the Coordinator have been capable of identifying four patient clusters, instrumental to define early and late complement activation. Building on this previous experience, here we will implement this strategy by combining omics approaches (i.e. WES, proteomics and
metabolomics) and hierarchical clustering analysis to define a precise stratification of patients with C3G/IC-MPGN, and to identify specific biomarkers, which will be instrumental for diagnosis, predicting prognosis and tailoring the right therapeutic strategy for the right patients, towards
personalized medicine. This proposal will offer also the unique opportunity to study a larger cohort of patients that will be in depth characterized for genetic and immune abnormalities in the various complement components, and for their clinical and biochemical characteristics.

Specific objectives are:

1) stratify patients into clusters and provide easy to handle platform to
assign patients to each them;

2) identify novel biomarkers of each cluster;

3) identify cluster specific therapies, and

4) design phase 2 clinical protocols.

DECODE will involve end users and engage with regulator and decision makers to ensure maximum exploitation and impact, taking into account ethical, legal and social implications.

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project leader at IZBI Dr. Henry Löffler Wirth

duration 01.03.2021 – 28.02.2024

joint project / third-party founding

international project partner

coordinator: Istituto di Ricerche Farmacologiche Mario Negri IRCCS Clinical Research Center for Rare Diseases „Aldo e Cele Daccò“ / Ranica (BG) / Italy / PhD Ariela Benigni