Serum Antibody and Glomerular Antigen of Antiphospholipase A2 Receptor in Chinese Patients with Idiopathic Membranous Nephropathy.

Abstract

BACKGROUND:

M-type phospholipase A2 receptor (PLA2R) is the first autoantigen responsible for idiopathic membranous nephropathy (IMN). However, serum PLA2R antibody (PLA2R-Ab) can be inaccurate in distinguishing between IMN and secondary membranous nephropathy, while renal PLA2R antigen (PLA2R-Ag) emerges as an ancillary diagnostic. The present study is aimed at examining the associations between PLA2R-Ab in sera and PLA2R-Ag in kidneys in IMN patients.

METHODS:

A total of 93 patients with IMN were retrospectively identified. Their serum PLA2R-Ab and renal PLA2R-Ag expression levels were determined, and the clinical correlations between these parameters and clinical features were examined.

RESULTS:

The sensitivities of serum PLA2R-Ab and renal PLA2R-Ag for diagnosing IMN were 74.2% and 88.2%, respectively (P < 0.001), with poor consistency. Higher serum PLA2R-Ab levels were correlated to stronger renal PLA2R-Ag expression (P = 0.048). Patients with positive PLA2R-Ab significantly differed from those with negative levels, in terms of proteinuric levels over 24 hours (4.54 vs. 3.46 g/day, P = 0.015) and serum albumin (23.28 vs. 27.95 g/L, P = 0.038). Among patients with positive renal PLA2R-Ag, patients with positive PLA2R-Ab had significantly higher 24-hour proteinuria, when compared to patients with negative PLA2R-Ab (4.57 vs. 3.08 g/day, P = 0.005). Among those with positive PLA2R-Ab in sera, their PLA2R-Ab levels were correlated with the estimated glomerular filtration and serum creatinine.

CONCLUSION:

Serum PLA2R-Ab exhibits a closer correlation with proteinuric severity and renal function, when compared to renal PLA2R-Ag.

• Authors: Qiu-Hua Zhang, Mian Wu, Zhi-Gang Hu, Xiao-Bin Liu, Biao Huang, Yi Zhang, Bin Liu, Yu-Shan Zhu, Liang Wang, Zhu-Xing Sun
• Journal: BioMed research international (Biomed Res Int) Vol. 2020 Pg. 1693710 ( 2020) ISSN: 2314-6141 [Electronic] United States
• PMID: 32461964 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Qiu-hua Zhang et al.

Chemical References

• Autoantibodies
• Autoantigens
• Biomarkers
• PLA2R1 protein, human
• Receptors, Phospholipase A2
• Serum Albumin
• Creatinine

Topics

• Asian People
• Autoantibodies (blood, immunology)
• Autoantigens (blood, immunology)
• Biomarkers (blood)
• Creatinine (blood)
• Glomerulonephritis, Membranous (blood, immunology)
• Humans
• Kidney (immunology)
• Kidney Glomerulus (immunology)
• Proteinuria
• Receptors, Phospholipase A2 (immunology)
• Retrospective Studies
• Serum Albumin (analysis)