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

Authors Wu X, Liu L, Guo Y, Yang L

Received 8 June 2018

Accepted for publication 9 August 2018

Published 20 September 2018 Volume 2018:11 Pages 241—247

DOI https://doi.org/10.2147/IJNRD.S176665

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 4

Editor who approved publication: Professor Pravin Singhal


Xueping Wu,1 Lei Liu,1 Yaling Guo,1 Lijuan Yang2

1Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People’s Republic of China; 2Department of Physiology, Bengbu Medical College, Bengbu, Anhui, People’s Republic of China

Objective: To compare the positive rate of anti-PLA2R antibodies in patients with primary membranous nephropathy (PMN), secondary membranous nephropathy (SMN), and non-membrane nephropathy (non-MN); evaluate serum anti-PLA2R antibodies in the diagnosis of PMN; quantify the serum anti-PLA2R antibody levels during the treatment of PMN patients; and evaluate the clinical value of monitoring changes in serum anti-PLA2R antibody quantification levels.
Methods: The kidney tissue was collected by kidney biopsy. The expression of PLA2R in glomeruli was detected by immunofluorescence, and ELISA was used to quantify the serum anti-PLA2R antibody. The positive rate of PLA2R expression in renal tissue and positive rate of the anti-PLA2R antibody in the three groups were compared and calculated using a statistical method. The specificity and coincidence rate of anti-PLA2R used in the differential diagnosis of PMN and SMN were evaluated. The clinical value of monitoring changes in serum anti-PLA2R antibody quantification levels was evaluated.
Result: The serum levels of the anti-PLA2R antibody were significantly higher in patients with PMN than in patients with SMN and non-MN group. The difference was statistically significant (P<0.05). The serum anti-PLA2R antibody became negative in the complete remission group. The serum anti-PLA2R antibody levels were significantly lower than before treatment in the partial remission group, and the difference was statistically significant (P<0.05). However, in the non-remission group, the serum anti-PLA2R antibody levels remained high.
Conclusion: Detection of the serum anti-PLA2R antibody has a high specificity for diagnosing PMN. The change of the serum anti-PLA2R antibody level is closely related to the status of the PMN: if the anti-PLA2R antibody level has decreased, it indicates that the condition has improved; and if the serum anti-PLA2R antibody continues to show high levels of positive or quantitative increase, the condition is not in remission or has relapsed.

Keywords: primary membranous nephropathy, phospholipase A2 receptor, serum anti-phospholipase A2 receptor antibody

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