Wu Xiaoxiang, Wen Si, Zhu Xuejing, Yuan Shuguang, Xu Xiangqing, Yang Danyi, Sun Lin, Liu Hong, Liu Fuyou
Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Apr 28;42(4):395-399. doi: 10.11817/j.issn.1672-7347.2017.04.005.
To examine the expression of phospholipase A2 receptor (PLA2R) in renal tissues and the level of anti-PLA2R antibody in serum in patients with idiopathic membranous nephropathy (IMN) and secondary membranous nephropathy (SMN), and to evaluate their diagnostic value in IMN. Methods: A total of 73 patients, who were diagnosed between May, 2014 and February, 2015 in the Department of Nephrology of the Second Xiangya Hospital, Central South University, were divided into three groups: an IMN group (n=48), an SMN group (n=17) and a minimal change disease group (n=8) according to the renal biopsy. PLA2R expression in renal tissues and the level of anti-PLA2R antibody in serum were detected by indirect immunofluorescence technique. Results: The positive rate and fluorescence intensity for PLA2R in the renal tissues in the IMN group were higher than those in the SMN group (91.7% in the IMN group vs 29.4% in the SMN group, P<0.05), while the positive rate and serum level for anti-PLA2R antibody in the IMN group were higher than those in the SMN group (85.4% in the IMN group vs 29.4% in the SMN group, P<0.05); the expression of PLA2R in renal tissues and the serum level for anti-PLA2R antibody were not detected in the minimal change disease group. The serum level of anti-PLA2R antibody was positively correlated with 24 h urine protein (r=0.432, P<0.01) and negatively correlated with serum albumin (r=-0.307, P<0.05). Conclusion: The expression of PLA2R in renal tissues and the serum level of anti-PLA2R antibody might be potential markers for diagnosis of IMN.
检测特发性膜性肾病（IMN）和继发性膜性肾病（SMN）患者肾组织中磷脂酶A2受体（PLA2R）的表达及血清中抗PLA2R抗体水平，并评估其对IMN的诊断价值。方法：选取2014年5月至2015年2月在中南大学湘雅二医院肾内科确诊的73例患者，根据肾活检结果分为三组：IMN组（n = 48）、SMN组（n = 17）和微小病变肾病组（n = 8）。采用间接免疫荧光技术检测肾组织中PLA2R表达及血清中抗PLA2R抗体水平。结果：IMN组肾组织中PLA2R阳性率及荧光强度高于SMN组（IMN组91.7% vs SMN组29.4%，P<0.05），IMN组抗PLA2R抗体阳性率及血清水平高于SMN组（IMN组85.4% vs SMN组29.4%，P<0.05）；微小病变肾病组未检测到肾组织中PLA2R表达及血清中抗PLA2R抗体水平。血清抗PLA2R抗体水平与24小时尿蛋白呈正相关（r = 0.432，P<0.01），与血清白蛋白呈负相关（r = -0.307，P<0.05）。结论：肾组织中PLA2R表达及血清抗PLA2R抗体水平可能是IMN诊断的潜在标志物。
