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

• Published in: Medicine (Baltimore) Vol. 96; no. 24; p. e7218
• Main Authors: Pang, Lu, Zhang, Ai-Min, Li, Hai-Xia, Du, Jia-Lin, Jiao, Li-Li, Duan, Nan, Liu, Yi, Yu, Dan
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health 01.06.2017
• Subjects: 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; Observational Study; Proteinuria - drug therapy; Proteinuria - metabolism; Proteinuria - pathology; Receptors, Phospholipase A2 - metabolism; Retrospective Studies; Sensitivity and Specificity; Serum Albumin - analysis
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000007218

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.