title: Novel quantitative method to evaluate globotriaosylceramide inclusions in renal peritubular capillaries by virtual microscopy in patients with fabry disease.
abstract: BACKGROUND
  Assessing the amount of globotriaosylceramide inclusions in renal peritubular capillaries by a semiquantitative approach is a standard and useful measure of therapeutic efficacy in Fabry disease, achievable by light microscopy analysis.
  
  
  OBJECTIVE
  To describe a novel virtual microscopy quantitative method to measure globotriaosylceramide inclusions (Barisoni Lipid Inclusion Scoring System [BLISS]) in renal biopsies from patients with Fabry disease.
  
  
  METHODS
  Plastic embedded 1-µm-thick sections from kidney biopsies from 17 patients enrolled in a Fabry disease clinical trial were evaluated using a standard semiquantitative methodology and BLISS to compare sensitivity. We also tested intrareader and interreader variability of BLISS and compared results from conventional light microscopy analysis with a virtual microscopy-based methodology. Peritubular capillaries were first annotated on digital images of whole slides by 1 pathologist and then scored for globotriaosylceramide inclusions by 2 additional pathologists.
  
  
  RESULTS
  We demonstrated that (1) quantitative analysis by BLISS results in detection of small amount of globotriaosylceramide inclusions even when by semiquantitative analysis the score is 0, (2) application of BLISS combined with conventional light microscopy results in low intrareader and interreader variability, and (3) BLISS combined with virtual microscopy results in significant reduction of intrareader and interreader variability compared with BLISS-light microscopy.
  
  
  CONCLUSIONS
  BLISS is a simpler and more sensitive scoring system compared to the semiquantitative approach. The virtual microscopy-based methodology increases accuracy and reproducibility; moreover, it provides a permanent record of retrievable data with full transparency in clinical trials.
authors: Department of Pathology and Medicine, New York University Langone Medical Center, New York, USA. barisl01@med.nyu.edu
authors: Laura
authors: L
authors: Barisoni
authors: J Charles
authors: JC
authors: Jennette
authors: Robert
authors: R
authors: Colvin
authors: Sheela
authors: S
authors: Sitaraman
authors: Alexander
authors: A
authors: Bragat
authors: Jeff
authors: J
authors: Castelli
authors: Dan
authors: D
authors: Walker
authors: Pol
authors: P
authors: Boudes
mesh_terms: D002196:Capillaries / Q000378:metabolism* / Q000648:ultrastructure; D000795:Fabry Disease / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000378:metabolism* / Q000648:ultrastructure; D008297:Male; D008853:Microscopy / Q000379:methods*; D014281:Trihexosylceramides / Q000378:metabolism*
chemical_list: D014281:Trihexosylceramides; C018549:globotriaosylceramide