Yıl: 2020 Cilt: 29 Sayı: 4 Sayfa Aralığı: 258 - 263 Metin Dili: İngilizce DOI: 10.5152/turkjnephrol.2020.3733 İndeks Tarihi: 05-05-2021

Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy

Öz:
Objective: The presence of autoantibodies against M-type phospholipase A2 receptor (anti-PLA2R) is a characteristic of id-iopathic membranous nephropathy (IMN). This study aimed to evaluate the presence, levels, and relationship of these an-tibodies with clinical parameters in idiopathic and secondary membranous nephropathy (MN) and IgA nephropathy (IgAN) in our country by indirect immunofluorescence (IFT) method.Materials and Methods: A total of 152 adult patients (97 IMN, 11 secondary MN, and 44 IgAN) were included. Serum an-ti-PLA2R levels were measured by IFT. All the kidney biopsies were evaluated in the same pathology laboratory.Results: A total of 54 of all patients with IMN were found to be anti-PLA2R-positive, but the patients with secondary MN and IgAN were anti-PLA2R-negative (p<0.001). At the time of diagnosis, when no treatment was administered yet, 42 patients were examined for anti-PLA2R, and 32 (76.1%) patients were found to be positive; 64.3% of the patients with currently ac-tive disease were anti-PLA2R-positive, and 82.6% of patients with partial or complete remissions were negative (p<0.001). In determining the disease activity, the sensitivity of anti-PLA2R was calculated as 73%, specificity as 82%, positive pre-dictive value as 92%, and negative predictive value as 51%. Anti-PLA2R titration was found to be positively correlated with proteinuria. In multivariate analysis of the factors affecting the level of proteinuria, only the presence of anti-PLA2R was significant.Conclusion: Anti-PLA2R was the main target in most Turkish patients with IMN, and investigation of the presence of an-ti-PLA2R using IFT is a very sensitive and unique method.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Beck LH, Jr., Bonegio RG, Lambeau G, Beck DM, Powell DW, Cummins TD, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med 2009; 361: 11-21. [Crossref]
  • 2. Timmermans SA, Abdul Hamid MA, Cohen Tervaert JW, Damoiseaux JG, van Paassen P, Limburg Renal R. Anti-PLA2R antibodies as a prognostic factor in PLA2R-related membranous nephropathy. Am J Nephrol 2015; 42: 70-7. [Crossref]
  • 3. Kim YG, Choi YW, Kim SY, Moon JY, Ihm CG, Lee TW, et al. Anti-phospholipase A2 receptor antibody as prognostic indicator in idiopathic membranous nephropathy. Am J Nephrol 2015; 42: 250-7. [Crossref]
  • 4. Hofstra JM, Beck LH, Jr., Beck DM, Wetzels JF, Salant DJ. Anti-phospholipase A(2) receptor antibodies correlate with clinical status in idiopathic membranous nephropathy. Clin J Am Soc Nephrol 2011; 6: 1286-91. [Crossref]
  • 5. Ruggenenti P, Debiec H, Ruggiero B, Chianca A, Pelle T, Gaspari F, et al. Anti-phospholipase A2 receptor antibody titer predicts post-rituximab outcome of membranous nephropathy. J Am Soc Nephrol 2015; 26: 2545-58. [Crossref]
  • 6. Dahan K, Debiec H, Plaisier E, Cachanado M, Rousseau A, Wakselman L, et al. Rituximab for severe membranous nephropathy: A 6-month trial with extended follow-up. J Am Soc Nephrol 2017; 28: 348-58. [Crossref]
  • 7. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerulonephritis Work Group. KDIGO clinical practice guideline for glomerulonephritis. Kidney Int Suppl 2012; 2: 139-274.
  • 8. Hoxha E, Harendza S, Zahner G, Panzer U, Steinmetz O, Fechner K, et al. An immunofluorescence test for phospholipase-A(2)-receptor antibodies and its clinical usefulness in patients with membranous glomerulonephritis. Nephrol Dial Transplant 2011; 26: 2526-32. [Crossref]
  • 9. Kanigicherla D, Gummadova J, McKenzie EA, Roberts SA, Harris S, Nikam M, et al. Anti-PLA2R antibodies measured by ELISA predict long-term outcome in a prevalent population of patients with idiopathic membranous nephropathy. Kidney Int 2013; 83: 940-8. [Crossref]
  • 10. Debiec H, Ronco P. PLA2R autoantibodies and PLA2R glomerular deposits in membranous nephropathy. N Engl J Med 2011; 364: 689-90. [Crossref]
  • 11. Qin W, Beck Jr. LH, Zeng C, Chen Z, Li S, Zuo K, et al. Anti-phospholipase A2 receptor antibody in membranous nephropathy. J Am Soc Nephrol 2011; 22: 1137-43. [Crossref]
  • 12. Beck Jr. LH, Fervenza FC, Beck DM, Bonegio RG, Malik FA, Erickson SB, et al. Rituximab-induced depletion of anti-PLA2R autoantibodies predicts response in membranous nephropathy. J Am Soc Nephrol 2011; 22: 1543-50. [Crossref]
  • 13. Ozturk S, Sumnu A, Seyahi N, Gullulu M, Sipahioglu M, Artan S, et al. Demographic and clinical characteristics of primary glomerular diseases in Turkey. Int Urol Nephrol 2014; 46: 2347-55. [Crossref]
APA Oto O, Yazici H, Caliskan Y, Artan A, Sever M, Cebeci E, Ozturk S, Turkmen A (2020). Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. , 258 - 263. 10.5152/turkjnephrol.2020.3733
Chicago Oto Ozgur Akin,Yazici Halil,Caliskan Yasar,Artan Ayse Serra,Sever Mehmet Sukru,Cebeci Egemen,Ozturk Savas,Turkmen Aydin Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. (2020): 258 - 263. 10.5152/turkjnephrol.2020.3733
MLA Oto Ozgur Akin,Yazici Halil,Caliskan Yasar,Artan Ayse Serra,Sever Mehmet Sukru,Cebeci Egemen,Ozturk Savas,Turkmen Aydin Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. , 2020, ss.258 - 263. 10.5152/turkjnephrol.2020.3733
AMA Oto O,Yazici H,Caliskan Y,Artan A,Sever M,Cebeci E,Ozturk S,Turkmen A Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. . 2020; 258 - 263. 10.5152/turkjnephrol.2020.3733
Vancouver Oto O,Yazici H,Caliskan Y,Artan A,Sever M,Cebeci E,Ozturk S,Turkmen A Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. . 2020; 258 - 263. 10.5152/turkjnephrol.2020.3733
IEEE Oto O,Yazici H,Caliskan Y,Artan A,Sever M,Cebeci E,Ozturk S,Turkmen A "Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy." , ss.258 - 263, 2020. 10.5152/turkjnephrol.2020.3733
ISNAD Oto, Ozgur Akin vd. "Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy". (2020), 258-263. https://doi.org/10.5152/turkjnephrol.2020.3733
APA Oto O, Yazici H, Caliskan Y, Artan A, Sever M, Cebeci E, Ozturk S, Turkmen A (2020). Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. Turkish journal of nephrology (Online), 29(4), 258 - 263. 10.5152/turkjnephrol.2020.3733
Chicago Oto Ozgur Akin,Yazici Halil,Caliskan Yasar,Artan Ayse Serra,Sever Mehmet Sukru,Cebeci Egemen,Ozturk Savas,Turkmen Aydin Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. Turkish journal of nephrology (Online) 29, no.4 (2020): 258 - 263. 10.5152/turkjnephrol.2020.3733
MLA Oto Ozgur Akin,Yazici Halil,Caliskan Yasar,Artan Ayse Serra,Sever Mehmet Sukru,Cebeci Egemen,Ozturk Savas,Turkmen Aydin Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. Turkish journal of nephrology (Online), vol.29, no.4, 2020, ss.258 - 263. 10.5152/turkjnephrol.2020.3733
AMA Oto O,Yazici H,Caliskan Y,Artan A,Sever M,Cebeci E,Ozturk S,Turkmen A Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. Turkish journal of nephrology (Online). 2020; 29(4): 258 - 263. 10.5152/turkjnephrol.2020.3733
Vancouver Oto O,Yazici H,Caliskan Y,Artan A,Sever M,Cebeci E,Ozturk S,Turkmen A Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy. Turkish journal of nephrology (Online). 2020; 29(4): 258 - 263. 10.5152/turkjnephrol.2020.3733
IEEE Oto O,Yazici H,Caliskan Y,Artan A,Sever M,Cebeci E,Ozturk S,Turkmen A "Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy." Turkish journal of nephrology (Online), 29, ss.258 - 263, 2020. 10.5152/turkjnephrol.2020.3733
ISNAD Oto, Ozgur Akin vd. "Presence of M-type Phospholipase A2 Receptor Antibody in Membranous Nephropathy". Turkish journal of nephrology (Online) 29/4 (2020), 258-263. https://doi.org/10.5152/turkjnephrol.2020.3733