Prof. Avila-Casado reveals new insights in nephrotic syndrome and dyslipidemia

Friday, January 24, 2014
Carmen Avila-Casado
LMP Professor Carmen Avila-Casado

Professor Avila-Casado (MD, PhD), Department of Laboratory Medicine (LMP), collaborating with a team from the University of Birmingham, Alabama, has revealed the importance of a biomarker called angiopoietin-like 4 for the development of hyperlipidemia in patients with nephrotic syndrome.

“The implications of this research are that if we can identify which patients have angiopoietin-like 4, we are confident that they will respond to treatment with a good prognosis,” said Prof. Avila-Casado.

As co-author of a recent publication in Nature Medicine, this research builds on her previous work that showed that angiopoietin-like 4 is a molecule that causes a kidney disorder called Minimal Change Disease. This disease is very common and is characterized by excess protein in the urine and can lead to swelling of the feet and legs, high blood pressure and high cholesterol.

Her current publication showed that angiopoietin-like 4 also is capable of producing an increase in blood lipids characteristically seen in those patients with minimal change disease. This new insight challenges the traditional idea of how nephrotic syndrome develops and will change the form of treatment.  

“This was a breakthrough because in the past, people believed that hyperlipidemia in nephrotic syndrome was an epiphenomenon, or happened as a result of liver compensation to the protein loss, but now we know that this molecule also causes hyperlipidemia,” said Prof. Avila-Casado.

For over ten years, Prof. Avila-Casado has collaborated with the group from the University of Birmingham, Alabama. She reviews tissue samples at Toronto General Hospital, and the team then analyzes the digital images over the Internet.

Her background as a pathologist, combined with the expertise of basic scientists and other clinicians, provides a unique perspective for the research, “As a pathologist, I have my own ideas of how to approach the glomerular disease, and, by working with nephrologists and basic scientists at the University of Birmingham, we’re able to see a more complete picture.”

Prof. Avila-Casado explained why it is more effective to study the causes of disease using both microscopic and molecular methods. “Sometimes what you see under the microscope isn’t precise because many diseases can look the same. But if you use another tool like biomarkers, your diagnosis is more accurate.”

Currently, the group at the University of Birmingham is developing a tool to easily measure angiopoietin-like 4.  The team is also studying biomarkers in other forms of glomerular disease like collapsing glomerulopathy.