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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
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Resource and Technical Advance Nephrology

Deep learning–based molecular morphometrics for kidney biopsies

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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

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Figure 5

Podocyte morphometric signature identifies ANCA-GN patients.

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Podocyte morphometric signature identifies ANCA-GN patients.
(A) Podocyt...
(A) Podocyte-morphometric analysis (podometrics; per glomerulus) showing a pattern of podocyte loss and hypertrophy in glomeruli classified as “normal” (without lesion) in ANCA-GN patients. (B) Principal component analysis (PCA) using Pareto scaling to rows. Probabilistic PCA was used to calculate principal components, confirming that normal glomeruli in ANCA-GN patients represent a transitional state between normal glomeruli in controls and lesions in ANCA-GN patients. In A and B, n = 722 normal glomeruli for controls and n = 373 glomeruli for ANCA-GN patients; Kruskal-Wallis with Dunn’s multiple-comparisons tests were performed. (C) Receiver operating characteristic (ROC), precision-recall curves, and confusion matrices of patient classification with a logistic regression using leave-one-out cross-validation based on eGFR and on a morphometric signature of podocyte depletion (PD), which combines morphometric data from every available glomerulus per biopsy per patient. (D) ROC, precision-recall curves, and confusion matrices for eGFR and PD signature as classifiers. In C and D, n = 48 patients for controls and n = 58 patients for ANCA-GN with PD signature; n = 62 patients for ANCA-GN with eGFR only. In violin plots, each gray dot represents 1 glomerulus, red lines represent medians, and blue lines represent IQRs. ANCA-GN, antineutrophil cytoplasmic antibody–associated glomerulonephritis; eGFR, estimated glomerular filtration rate; TPR, true positive rate; FPR, false positive rate. ****P < 0.0001, ***P < 0.001, and *P < 0.05.

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ISSN 2379-3708

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