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. 2011 Jun;6(6):1286-91.
doi: 10.2215/CJN.07210810. Epub 2011 Apr 7.

Anti-phospholipase A₂ receptor antibodies correlate with clinical status in idiopathic membranous nephropathy

Julia M Hofstra  1 , Laurence H Beck Jr, David M Beck, Jack F Wetzels, David J Salant
Affiliations

Anti-phospholipase A₂ receptor antibodies correlate with clinical status in idiopathic membranous nephropathy

Julia M Hofstra et al. Clin J Am Soc Nephrol. 2011 Jun.

Abstract

Background and objectives: Circulating autoantibodies against the M-type phospholipase A(2) receptor (anti-PLA(2)R) were recently identified in the majority of patients in the United States with idiopathic membranous nephropathy (iMN). The objectives of this study were to assess the prevalence of anti-PLA(2)R in a separate, European cohort of iMN patients and to correlate the presence of anti-PLA(2)R with clinical parameters reflective of disease activity.

Design, setting, participants, & measurements: Anti-PLA(2)R levels were blindly assessed by a Western blot immunoassay in 54 serum samples from 18 patients with iMN collected in various stages of clinical disease. Anti-PLA(2)R levels were correlated with other clinical parameters.

Results: 77.8% of iMN patients in our cohort had antibodies reactive with human PLA(2)R. The antibody levels in these patients correlated strongly with both clinical status and proteinuria (r = 0.73, P < 0.01).

Conclusions: The role of PLA(2)R as a major antigen in iMN was confirmed in an independent, European patient cohort, and levels of circulating anti-PLA(2)R revealed a strong correlation with clinical disease activity. We propose that detection and measurement of these autoantibodies may provide a tool for monitoring of disease activity and treatment efficacy.

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Figures

Figure 1.
Figure 1.
Correlation between the anti-PLA2R antibody level and proteinuria (baseline samples, n = 14).
Figure 2.
Figure 2.
Anti-PLA2R-autoantibody levels during the clinical course of 13 anti-PLA2R-positive patients with remission of proteinuria during follow-up. Nephrotic, sample taken during period of proteinuria >3.5 g/d with serum albumin <3.0 g/dl; Remission, sample taken during clinical remission with proteinuria <3.5 g/d; Relapse, sample taken during clinical relapse of proteinuria >3.5 g/d after a period of remission.
Figure 3.
Figure 3.
Correlation between the anti-PLA2R antibody level and proteinuria. All of the samples were taken during the clinical course (n = 46) from 14 patients with positive aPLA2R antibodies at baseline.
See this image and copyright information in PMC

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