Características clínicas, evolución y pronóstico de la nefropatía membranosa idiopática en función de la presencia de anticuerpos contra el receptor tipo M de la fosfolipasa A2

Escalante, Elías Jatem; Medrano, Alfons Segarra; Cáceres, Clara Carnicer; Martín-Gómez, M. Adoración; Allende, M.T.; Roldan, Helena Ostos; Pamplona, Irene Agraz

doi:10.1016/j.nefro.2015.05.026

Cited by 8 publications

(5 citation statements)

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“…It has been suggested that in the patients with anti-PLA2R antibody-associated PMN, the antibody titer might be used to predict prognosis, supposing that there is a lag between the immunological and clinical response [ 15 ]. Despite the fact that around 30% of patients with PMN are anti-PLA2R-negative, even in their renal tissue, little information is available on these patients [ 16 ]. Most studies using PLA2R to predict prognosis focused on the anti-PLA2R status of the patients, and few considered the glomerular PLA2R antigen [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of primary membranous nephropathy based on serum anti-phospholipase A2 receptor antibodies and glomerular phospholipase A2 receptor antigen status: a retrospective cohort study

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Outcomes of primary membranous nephropathy based on serum anti-phospholipase A2 receptor antibodies and glomerular phospholipase A2 receptor antigen status: a retrospective cohort study

et al. 2020

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“…In terms of aetiology, MN is most often primary (pMN 80%)—formerly named idiopathic MN—but may be secondary to a variety of conditions, including systemic lupus erythematosus, hepatitis B antigenaemia, malignancy and the use of certain drugs or toxins [1, 5]. It was not until 2009, when antibodies against M-type phospholipase A2 receptor (APLA2R) were discovered, that an underlying cause could be identified to explain the pMN in a great proportion of cases [2–4, 6, 9].…”

Section: Introductionmentioning

confidence: 99%

Antiphospholipase 2 receptor antibody levels to predict complete spontaneous remission in primary membranous nephropathy

Rodas

Matas‐García

Barros

et al. 2018

Clinical Kidney Journal

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BackgroundM-type phospholipase A2 receptor (APLA2R) is considered the major antigen involved in the pathogenesis of adult primary membranous nephropathy (MN), which is the leading cause of non-diabetic nephrotic syndrome. Antibodies to this antigen have been proved to be an excellent biomarker of disease activity in primary MN. In fact, preliminary data suggest that the higher the antibody level the more proteinuria, and that a decrease in antibody level precedes the remission of proteinuria, but more solid evidence is needed.MethodsThe present work aims to characterize the predictive value of the level of antibodies against PLA2R as a biomarker of disease course and treatment response in a well-defined cohort of 62 patients from University Hospitals Clinic of Barcelona and Josep Trueta in Girona. The primary outcome was the appearance of a spontaneous complete remission (CR), defined as induction of a CR without the use of immunosuppressive agents.ResultsIn common with other reports, this work confirms that spontaneous CR is more frequent in patients with low titre of APLA2R at diagnosis, but strikingly, in this cohort we found that spontaneous CR was achieved in patients with APLA2R levels <40 UI/mL. Furthermore, spontaneous CR were less frequently observed in patients with proteinuria >8 g/day.ConclusionsIn conclusion, these findings point out the important role of APLA2R as a tool to predict the disease course and establish personalized therapeutic options at the moment of diagnosis of primary MN. Specifically, patients with low titre of APLA2R (<40 UI/mL) and proteinuria <4/day could obtain benefit of a longer period of follow-up with conservative treatment after diagnosis.

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“…Las características demográficas de los pacientes con NM aparentemente primaria (Tabla 1), revelan predominio de población masculina y edad promedio entre 50 a 60 años, características semejantes a lo descrito en otros trabajos 9,10 .…”

Section: Discussionunclassified

“…Los aspectos clínicos en relación al síndrome nefrótico fueron semejantes en los pacientes con Ac anti-PLA2R positivo y negativo, al igual que lo publicado por Hofstra et al 9 y Escalante et al 10 , salvo la magnitud de la proteinuria que fue claramente mayor en el grupo con Ac anti-PLA2R positivo, no descrito en otras series. La prevalencia del Ac anti-PLA2R sérico en esta serie fue de 53,6% (15/28), semejante aunque en el límite inferior a lo reportado por otros investigadores 10,11,18 . Este hallazgo puede ser explicado porque es una muestra pequeña o porque se trata de una población distinta.…”

Section: Discussionunclassified

“…Nuestro estudio muestra que en pacientes con NM aparentemente primaria, existe una elevada concordancia en la presencia del anticuerpo Ac anti-PLA2R sérico e histológico, similar a lo reportado en otras series 9,10 . La gran especificidad cuando se la compara con la IHQ renal permitiría hacer el diagnóstico de NM cuando es positivo sin necesidad de realizar una biopsia renal, procedimiento invasivo, riesgoso y caro.…”

Section: Discussionunclassified

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Prevalencia del anticuerpo anti receptor de fosfolipasa A2 sérico e histológico en pacientes con nefropatía membranosa en un Centro Universitario

et al. 2021

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Phospholipase A2 receptor antigen antibodies in serum and renal biopsies of patients with membranous nephropathyBackground: The discovery of the phospholipase A2 receptor antigen and its highly specific autoantibody (anti-PLA2R Ab) was useful for the diagnosis and follow-up of patients with membranous nephropathy (MN). Thus, some international guidelines recommend not performing renal biopsy in patients with positive serum anti-PLA2R Ab. Aim: To evaluate the prevalence of anti-PLA2R Ab in serum and renal tissue samples from Chilean patients with primary MN. Material and Methods: Twenty-eight patients aged 50 ± 14 years (20 males) with biopsy-proven primary MN plus a negative workup for secondary causes were included. Measurements of serum and renal histologic anti-PLA2R Ab were performed. The relationship between the findings of serum and tissue anti-PLA2R Ab was evaluated. Results: Fifteen patients (54 %) had anti-PLA2R Ab presence in serum and 19 patients (68%) had positive anti-PLA2R Ab in the renal biopsy. All patients with positive serum anti-PLA2R Ab had positive antibodies on immunohistochemistry. Conclusions: Serum anti-PLA2R Ab is potentially useful in the diagnosis of patients with suspected primary MN in Chilean population.

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Características clínicas, evolución y pronóstico de la nefropatía membranosa idiopática en función de la presencia de anticuerpos contra el receptor tipo M de la fosfolipasa A2

Abstract: Anti-PLA2R-negative patients with idiopathic membranous nephropathy were older and experienced spontaneous remission more often than anti-PLA2R-positive patients. No differences in terms of treatment response, recurrences, and final prognosis were observed between both groups of patients.

Cited by 8 publications

References 23 publications

Outcomes of primary membranous nephropathy based on serum anti-phospholipase A2 receptor antibodies and glomerular phospholipase A2 receptor antigen status: a retrospective cohort study

Outcomes of primary membranous nephropathy based on serum anti-phospholipase A2 receptor antibodies and glomerular phospholipase A2 receptor antigen status: a retrospective cohort study

Antiphospholipase 2 receptor antibody levels to predict complete spontaneous remission in primary membranous nephropathy

Prevalencia del anticuerpo anti receptor de fosfolipasa A2 sérico e histológico en pacientes con nefropatía membranosa en un Centro Universitario

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