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. 2014 Jul;142(1):29-34.
doi: 10.1309/AJCP8QMOY5GLRSFP.

Evaluation of anti-PLA2R1 as measured by a novel ELISA in patients with idiopathic membranous nephropathy: a cohort study

Sjoerd A M E G Timmermans  1 , Jan G M C Damoiseaux  2 , Petra T J Heerings-Rewinkel  2 , Rivka Ayalon  3 , Laurence H Beck Jr  3 , Wolfgang Schlumberger  4 , David J Salant  3 , Pieter van Paassen  5 , Jan Willem Cohen Tervaert  6 ; Limburg Renal Registry
Collaborators, Affiliations

Evaluation of anti-PLA2R1 as measured by a novel ELISA in patients with idiopathic membranous nephropathy: a cohort study

Sjoerd A M E G Timmermans et al. Am J Clin Pathol. 2014 Jul.

Abstract

Objectives: Autoantibodies against the M-type phospholipase A2 receptor 1 (anti-PLA2R1) have been demonstrated to be very specific for idiopathic membranous nephropathy (MN). We studied a novel enzyme-linked immunosorbent assay (ELISA) and compared results with results obtained using an indirect immunofluorescence (IIF) and a Western blotting test (WB).

Methods: One-hundred nine patients with idiopathic MN were recruited between November 1979 and March 2011. The control cohort comprised serum samples from patients with secondary MN (n = 16) and nephrotic controls (n = 17). The presence of anti-PLA2R1 in serum samples obtained at the time of renal biopsy was determined using ELISA, IIF, and WB.

Results: With similar specificity (≥ 97%), sensitivity varied from 68% (IIF) to 72% (ELISA, WB). Remarkably, patients who were seronegative for anti-PLA2R1 more often entered spontaneous remission (P = .038), whereas seropositive patients were more frequently treated with immunosuppressive agents (P < .001).

Conclusions: ELISA performs excellently in differentiating idiopathic from secondary MN. Furthermore, ELISA shared high agreement with WB and IIF.

Keywords: ELISA; Membranous nephropathy; Nephrotic syndrome; Phospholipase A2 receptor 1; Sensitivity and specificity.

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