Virus-related collapsing glomerulopathy, a common mechanism of injury?

Collapsing glomerulopathy frequently shows focal lesions on biopsy, creating challenges with transcriptomic investigations because of inadequate tissue sample. This challenge is overcome with spatial transcriptomics, technology linking transcriptomic data to histology. Applying this technology to investigate patients with collapsing glomerulopathy related to HIV infection or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Smith et al. provide provocative evidence that collapsing glomerulopathy may have different molecular signatures despite the similar morphologic appearance. Collapsing glomerulopathy frequently shows focal lesions on biopsy, creating challenges with transcriptomic investigations because of inadequate tissue sample. This challenge is overcome with spatial transcriptomics, technology linking transcriptomic data to histology. Applying this technology to investigate patients with collapsing glomerulopathy related to HIV infection or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Smith et al. provide provocative evidence that collapsing glomerulopathy may have different molecular signatures despite the similar morphologic appearance. Digital spatial profiling of collapsing glomerulopathyKidney InternationalVol. 101Issue 5PreviewCollapsing glomerulopathy is a histologically distinct variant of focal and segmental glomerulosclerosis that presents with heavy proteinuria and portends a poor prognosis. Collapsing glomerulopathy can be triggered by viral infections such as HIV or SARS-CoV-2. Transcriptional profiling of collapsing glomerulopathy lesions is difficult since only a few glomeruli may exhibit this histology within a kidney biopsy and the mechanisms driving this heterogeneity are unknown. Therefore, we used recently developed digital spatial profiling (DSP) technology which permits quantification of mRNA at the level of individual glomeruli. Full-Text PDF