Go to The Journal of Clinical Investigation
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
  • Physician-Scientist Development
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Immunology
    • Metabolism
    • Nephrology
    • Oncology
    • Pulmonology
    • All ...
  • Videos
  • Collections
    • In-Press Preview
    • Resource and Technical Advances
    • Clinical Research and Public Health
    • Research Letters
    • Editorials
    • Perspectives
    • Physician-Scientist Development
    • Reviews
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • In-Press Preview
  • Resource and Technical Advances
  • Clinical Research and Public Health
  • Research Letters
  • Editorials
  • Perspectives
  • Physician-Scientist Development
  • Reviews
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
Deep learning–based molecular morphometrics for kidney biopsies
Marina Zimmermann, Martin Klaus, Milagros N. Wong, Ann-Katrin Thebille, Lukas Gernhold, Christoph Kuppe, Maurice Halder, Jennifer Kranz, Nicola Wanner, Fabian Braun, Sonia Wulf, Thorsten Wiech, Ulf Panzer, Christian F. Krebs, Elion Hoxha, Rafael Kramann, Tobias B. Huber, Stefan Bonn, Victor G. Puelles
Marina Zimmermann, Martin Klaus, Milagros N. Wong, Ann-Katrin Thebille, Lukas Gernhold, Christoph Kuppe, Maurice Halder, Jennifer Kranz, Nicola Wanner, Fabian Braun, Sonia Wulf, Thorsten Wiech, Ulf Panzer, Christian F. Krebs, Elion Hoxha, Rafael Kramann, Tobias B. Huber, Stefan Bonn, Victor G. Puelles
View: Text | PDF
Resource and Technical Advance Nephrology

Deep learning–based molecular morphometrics for kidney biopsies

  • Text
  • PDF
Abstract

Morphologic examination of tissue biopsies is essential for histopathological diagnosis. However, accurate and scalable cellular quantification in human samples remains challenging. Here, we present a deep learning–based approach for antigen-specific cellular morphometrics in human kidney biopsies, which combines indirect immunofluorescence imaging with U-Net–based architectures for image-to-image translation and dual segmentation tasks, achieving human-level accuracy. In the kidney, podocyte loss represents a hallmark of glomerular injury and can be estimated in diagnostic biopsies. Thus, we profiled over 27,000 podocytes from 110 human samples, including patients with antineutrophil cytoplasmic antibody–associated glomerulonephritis (ANCA-GN), an immune-mediated disease with aggressive glomerular damage and irreversible loss of kidney function. We identified previously unknown morphometric signatures of podocyte depletion in patients with ANCA-GN, which allowed patient classification and, in combination with routine clinical tools, showed potential for risk stratification. Our approach enables robust and scalable molecular morphometric analysis of human tissues, yielding deeper biological insights into the human kidney pathophysiology.

Authors

Marina Zimmermann, Martin Klaus, Milagros N. Wong, Ann-Katrin Thebille, Lukas Gernhold, Christoph Kuppe, Maurice Halder, Jennifer Kranz, Nicola Wanner, Fabian Braun, Sonia Wulf, Thorsten Wiech, Ulf Panzer, Christian F. Krebs, Elion Hoxha, Rafael Kramann, Tobias B. Huber, Stefan Bonn, Victor G. Puelles

×

Figure 4

Molecular podometrics reveal podocyte loss in patients with ANCA-GN.

Options: View larger image (or click on image) Download as PowerPoint
Molecular podometrics reveal podocyte loss in patients with ANCA-GN.
(A)...
(A) Podocyte morphometric analysis (podometrics; median per patient) showing reductions in podocyte numbers and densities, as well as increases in podocyte sizes and closest neighbor distances in ANCA-GN patients compared with controls. (B) Spearman’s rank correlation analyses confirm a pattern of podocyte loss across the entire range of glomerular volume. (C) Increases in podocyte closest neighbor distances are associated with reductions in podocyte density. (D) ANCA-GN patients have a lower estimated glomerular filtration rate (eGFR) at the time of biopsy compared with controls; features of podocyte depletion are associated with eGFR at biopsy. (E) Receiver operating characteristic (ROC) and precision-recall curves of a logistic regression using leave-one-out cross-validation showing the discrimination power of combined podometrics (podocyte number, density, and size), including confusion matrix. In all panels n = 48 patients for controls and n = 62 patients for ANCA-GN; Mann-Whitney U tests were performed. In violin plots, each gray dot represents the median value per subject, red lines represent medians, and blue lines represent IQRs. Regression lines represent lines of best fit and 95% CI. ANCA-GN, antineutrophil cytoplasmic antibody–associated glomerulonephritis; eGFR, estimated glomerular filtration rate; TPR, true positive rate; FPR, false positive rate. ****P < 0.0001, **P < 0.01, and *P < 0.05.

Copyright © 2026 American Society for Clinical Investigation
ISSN 2379-3708

Sign up for email alerts