Clinical value of a serum anti-PLA2R antibody in the diagnosis and monitoring of primary membranous nephropathy in adults

Wu, Xueping; Liu, Lei; Guo, Yaling; Yang, Lijuan

doi:10.2147/ijnrd.s176665

Cited by 16 publications

(20 citation statements)

References 20 publications

(17 reference statements)

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“…Thus, for a threshold of 239.95 RU/ml, the sensitivity and the specificity of anti-PLA2R Ab in predicting non-remission were 100% and 87.5%. Significant higher levels of anti-PLA2 Ab in non-remission patients was also reported by previous studies [25,26] and confirmed by the meta-analysis of Liang et al [23]. In this meta-analysis, PMN patients with high titers of PLA2R Ab had 0.72-fold (95% CI: 0.59-0.87, p = 0.0006) decreased chance of achieving clinical remission [23].…”

Section: Plos Onesupporting

confidence: 84%

“…In this meta-analysis, PMN patients with high titers of PLA2R Ab had 0.72-fold (95% CI: 0.59-0.87, p = 0.0006) decreased chance of achieving clinical remission [23]. In a recent study [26], sera from patients with high levels of anti-PLA2R Ab showed a multiple reactivity to CTLD1 and CTLD7 domains in addition to CysR domain, p<0.001. These so-called spreaders patients had more severe proteinuria and epitope-spreading was an independent risk factor for decreased remission rate; OR [95% CI] = 0.16 [0.04-0.72], p = 0.02 [27].…”

Section: Plos Onementioning

confidence: 69%

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PLA2R antibody, PLA2R rs4664308 polymorphism and PLA2R mRNA levels in Tunisian patients with primary membranous nephritis

et al. 2020

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Background Primary membranous nephritis (PMN) is an autoimmune disease induced by the deposit of antibodies (Ab) to the phospholipase receptor A2 receptor (PLA2R) on podocytes. In this context, we aimed to assess the relationships between anti-PLA2R Ab, PLA2R rs4664308 SNP, PLA2R mRNA levels and PMN susceptibility and outcome. Methods Sixty-eight PMN patients, 30 systemic lupus erythematosus (SLE) patients with secondary MN and 30 healthy control subjects served for anti-PLA2R Ab measurement by ELISA and PLA2R rs4664308 SNP genotyping by a commercial real-time PCR. Twenty patients with tubulo-interstitial nephritis (TIN) were used as controls for renal PLA2R mRNA quantification in PMN patients from kidney biopsies. PLA2R mRNA quantification was carried-out by realtime PCR after RNA extraction. Results Forty-three (63.2%) PMN patients received initial therapy consisting of alternating monthly cycles of corticosteroids and cyclophosphamide. Twelve (17.6%) patients had resistant PMN to initial therapy and were consecutively treated by cyclosporine or tacrolimus. Anti-PLA2R Ab were positive in 54 (79.4%) PMN patients, while all SLE patients and controls were negative, p<0.0001. Moreover, anti-PLA2R Ab levels were significantly higher in PMN patients (134.85 [41.25-256.97] RU/ml) than in SLE patients (3.35 [2.3-4.35] RU/ml) and controls (2 [2-2.3]), p<0.0001. Consequently, a ROC curve showed for 100% specificity a sensitivity of 94.1% at a threshold of 2.6 RU/ml. Besides, Anti-PLA2R antibodies levels were significantly associated to non-remission; p = 0.002.

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Section: Plos Onesupporting

confidence: 84%

Section: Plos Onementioning

confidence: 69%

PLA2R antibody, PLA2R rs4664308 polymorphism and PLA2R mRNA levels in Tunisian patients with primary membranous nephritis

et al. 2020

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“…It was widely reported that biomarker like PLA 2 R Ab could be used to monitor subjects with primary MGN [20,21]. Therefore, positive detection of anti-PLA 2 R Ab in 13 subjects and anti-THSD7A Ab in four subjects with biopsy-proven primary MGN after a prolonged period of follow-up justified the importance of these biomarkers in monitoring MGN.…”

Section: Role Of Biomarkers In Monitoring Mgn Subjectsmentioning

confidence: 90%

RETRACTED: Role of Serum and Urine Biomarkers (PLA2R and THSD7A) in Diagnosis, Monitoring and Prognostication of Primary Membranous Glomerulonephritis

et al. 2020

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Differentiating primary and secondary membranous glomerulonephritis (MGN) using biomarkers for MGN is essential in patients’ diagnosis, treatment and follow-up. Although biopsy has been the primary tool in making the diagnosis, not all patients can withstand it due to its invasive nature, and it cannot be used to monitor treatment. Hence, there is the need for less invasive or even non-invasive biomarkers for effective diagnosis, treatment monitoring and prognostication. This study aimed at providing an alternative way of differentiating primary and secondary MGN using enzyme-linked immunosorbent assay (ELISA) technique for serum and urine biomarkers (M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A)) for prompt diagnosis, treatment and prognosis. A total of 125 subjects, including 81 primary and 44 secondary MGN subjects, were diagnosed from January 2012 to October 2019 at Hospital Serdang and Hospital Kuala Lumpur from which 69 subjects consisting of 47 primary and 22 secondary MGN subjects participated in the study. Of these, 13 primary MGN subjects were positive for both serum and urine anti-PLA2R antibodies (Ab) whereas only one secondary MGN subject associated with hepatitis B virus was positive for both serum and urine anti-PLA2R Ab. At the same time, anti-THSD7A Ab was found positive in four primary MGN subjects and two secondary MGN subjects with malignancy.

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“…Most ELISA authors define positivity of anti-PLA 2 R using a cut-off point of 20 RU/mL, some use 14 RU/mL, 2.6 RU/mL, or 2 RU/mL as their cut-off point value to define positivity [89][90][91][92]. In some cases, the cut-off point value is obtained by measuring the anti-PLA 2 R of apparently normal subjects without any renal compromised [93].…”

Section: Diagnosismentioning

confidence: 99%

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

et al. 2019

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The detection of phospholipase A2 receptor (PLA2R) and thrombospondin domain containing 7A THSD7A among primary membranous glomerulonephritis (MGN) patients transformed the diagnosis, treatment monitoring, and prognosis. Anti-PLA2R can be detected in 70–90% of primary MGN patients while anti-THSD7A in 2–3% of anti-PLA2R negative primary MGN patients depending on the technique used. Serum and urine samples are less invasive and non-invasive, respectively, and thus can detect the presence of anti-PLA2R and anti-THSD7A with higher sensitivity and specificity, which is significant in patient monitoring and prognosis. It is better than exposing patients to a frequent biopsy, which is an invasive procedure. Different techniques of detection of PLA2R and THSD7A in patients’ urine and sera were reviewed to provide newer and alternative techniques. We proposed the use of biomarkers (PLA2R and THSD7A) in the diagnosis, treatment decision, and follow-up of patients with primary MGN. In addition, other prognostic renal biomarkers like retinol binding protein (RBP) and beta-2 microglobulin were reviewed to detect the progression of renal damage for early intervention.

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Clinical value of a serum anti-PLA2R antibody in the diagnosis and monitoring of primary membranous nephropathy in adults

Cited by 16 publications

References 20 publications

PLA2R antibody, PLA2R rs4664308 polymorphism and PLA2R mRNA levels in Tunisian patients with primary membranous nephritis

PLA2R antibody, PLA2R rs4664308 polymorphism and PLA2R mRNA levels in Tunisian patients with primary membranous nephritis

RETRACTED: Role of Serum and Urine Biomarkers (PLA2R and THSD7A) in Diagnosis, Monitoring and Prognostication of Primary Membranous Glomerulonephritis

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

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