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Clin Chim Acta. 2019 Mar;490:135-141. doi: 10.1016/j.cca.2018.12.027. Epub 2018 Dec 31.

Serum phospholipase A2 receptor antibodies and immunoglobulin G subtypes in adult idiopathic membranous nephropathy: Clinical value assessment.

Author information

1
Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China.
2
Department of Laboratory Medicine, Yan'an People's Hospital, Yanan, China.
3
Department of Laboratory Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
4
Department of Laboratory Medicine, The Second Hospital of Dalian Medical University, Dalian, China.
5
Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
6
Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China. Electronic address: qinxs@sj-hospital.org.

Abstract

BACKGROUND:

Idiopathic membranous nephropathy (IMN) is widely considered as an organ-specific autoimmune disorder. Implicated in its pathogenesis are the phospholipase A2 receptors (PLA2R) expressed on glomerular podocytes against which serum antibodies are formed. In this study we quantified and assessed the clinical value of total serum PLA2R antibodies and the subtype antibodies in IMN.

METHODS:

We measured serum levels of total PLA2R antibodies and IgG subtype antibodies by Enzyme Linked Immunosorbent Assay (ELISA) in 146 biopsy-proven IMN patients, 51 non-IMN patients and 62 healthy controls. We went ahead and determined the diagnostic potential of total serum PLA2R antibodies and assessed if a relationship exists between the dominat subtype antibody and the clinical parameters.

RESULTS:

The diagnostic sensitivity and specificity of total serum PLA2R antibody for IMN were found at 69.9% and 100% respectively. Significant differences in systolic blood pressure, serum Cystatin C, serum albumin and estimated glomerular filtration rate (eGFR) were found between the antibody-positive and antibody-negative groups of IMN patients. Subtype antibody 4 and 1 exhibited the highest positive rates of 94.4% and 91.6% respectively. The mean serum proportion of subtype antibodies was 65.4, 12.7, 7.6 and 4.6% for subtype 4, 1, 3 and 2 respectively. Serum levels of total protein and albumin were significantly decreased among patients with high serum titres of antibody subtype 4.

CONCLUSION:

Our findings underscore the diagnostic potential of total serum PLA2R antibodies and highlight the importance of antibody subtype 4 over other subtype antibodies in IMN.

KEYWORDS:

Glomerular basement membrane; Idiopathic membranous nephropathy; PLA2R; Subtype antibody

PMID:
30605630
DOI:
10.1016/j.cca.2018.12.027
[Indexed for MEDLINE]

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