2021
DOI: 10.1016/j.xkme.2021.03.013
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Abstract: Technological advances have allowed the discovery of 6 subtypes of membranous nephropathy based on target antigens: M-type phospholipase A 2 receptor (PLA 2 R), thrombospondin type 1 domain-containing 7A (THSD7A), neural epidermal growth factor-like 1 protein, semaphorin 3B, exostosin 1 (EXT1), and EXT2. EXT1/EXT2 are thought to be associated with secondary (autoimmune) membranous nephropathy. Although it has been reported that PLA 2 R-and THSD7A-associated membranous nephropathy have rarely been detected conc… Show more

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Cited by 10 publications
(4 citation statements)
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“…Our results suggested that Ext1/Ext2 could occur without the presence of autoimmune diseases. Interestingly, our study included two patients with Ext1/Ext2-associated MN that showed positive staining for other podocyte antigens 31 . Further case accumulation is needed to clarify the roles and features of Ext1/Ext2-associated MN.…”
Section: Discussionmentioning
confidence: 99%
“…Our results suggested that Ext1/Ext2 could occur without the presence of autoimmune diseases. Interestingly, our study included two patients with Ext1/Ext2-associated MN that showed positive staining for other podocyte antigens 31 . Further case accumulation is needed to clarify the roles and features of Ext1/Ext2-associated MN.…”
Section: Discussionmentioning
confidence: 99%
“…Neither our study nor the studies of Sethi and coworkers (9) found exostosin positive in patients with primary PLA2R membranous nephropathy. However, two patients with primary membranous nephropathy were found to be exostosin positive in a recent report (16), suggesting that the relationship between exostosin and membranous nephropathy needs to be further studied.…”
Section: Discussionmentioning
confidence: 96%
“…Intramolecular epitope spreading, as described above, may be more common than intermolecular epitope spreading. Rare reports of dual positivity for antigenic targets has been observed with concurrent PLA2R and THSD7A-positive cases (202), PLA2R and EXT1/2 co-positivity (203), THSD7A and EXT1/2 co-positivity (203), and dual NCAM1 and EXT1/2 staining (32). However, no study has shown that one autoimmune reaction predated the other, so the existence of intermolecular epitope spreading (i.e., antibody-mediated cytotoxicity due to one antigen resulting in exposure of the second protein to the immune system) is only speculative.…”
Section: Epitope Spreadingmentioning
confidence: 99%