Serum anti-PLA2R antibody and glomerular PLA2R deposition in Chinese patients with membranous nephropathy: A cross-sectional study

Medicine (Baltimore). 2017 Jun;96(24):e7218. doi: 10.1097/MD.0000000000007218.

Abstract

M-type phospholipase A2 receptor (PLA2R) is the major target antigen in primary membranous nephropathy (PMN). Previous studies have evaluated the diagnostic value of serum anti-PLA2R antibody. However, the correlation of serum anti-PLA2R antibody and glomerular PLA2R deposition, and their association with clinical characteristics need to be further evaluated.A total of 136 patients were involved as inception group because serum anti-PLA2R antibody and glomerular PLA2R antigen were simultaneously measured. We examined serum anti-PLA2R antibody by ELISA and glomerular PLA2R deposition by immunofluorescence assay.Positive serum anti-PLA2R antibody and glomerular PLA2R deposition were seen in 58.8% (80/136) and 95.6% (130/136) patients, respectively (P < .001). Proteinuria, serum total protein, serum albumin, serum creatinine, and estimated glomerular filtration rate (eGFR) had significant differences between patients with serum anti-PLA2R antibody and those without. Serum anti-PLA2R antibody levels were correlated with serum albumin, serum creatinine, eGFR, and proteinuria. Glomerular PLA2R deposition intensities were weakly correlated with proteinuria. Unexpectedly, there was a positive correlation rather than a negative correlation between glomerular PLA2R deposition intensity and eGFR.In conclusion, serum anti-PLA2R antibody is more closely correlated with disease activity and renal function than glomerular PLA2R deposition.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Autoantibodies / blood*
  • Biomarkers / metabolism
  • China
  • Creatinine / blood
  • Cross-Sectional Studies
  • Enzyme-Linked Immunosorbent Assay
  • Fluorescent Antibody Technique
  • Glomerular Filtration Rate
  • Glomerulonephritis, Membranous / drug therapy
  • Glomerulonephritis, Membranous / metabolism*
  • Glomerulonephritis, Membranous / pathology
  • Humans
  • Immunoglobulin G / metabolism*
  • Kidney / metabolism*
  • Kidney / pathology
  • Proteinuria / drug therapy
  • Proteinuria / metabolism
  • Proteinuria / pathology
  • Receptors, Phospholipase A2 / metabolism*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Serum Albumin / analysis

Substances

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