Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China.
Nanjing Medical University, Nanjing 211166, China.
Biomed Res Int. 2020 May 8;2020:1693710. doi: 10.1155/2020/1693710. eCollection 2020.
M-type phospholipase A2 receptor (PLA2R) is the first autoantigen responsible for idiopathic membranous nephropathy (IMN). However, serum PLA2R antibody (PLA2R-Ab) can be inaccurate in distinguishing between IMN and secondary membranous nephropathy, while renal PLA2R antigen (PLA2R-Ag) emerges as an ancillary diagnostic. The present study is aimed at examining the associations between PLA2R-Ab in sera and PLA2R-Ag in kidneys in IMN patients.
A total of 93 patients with IMN were retrospectively identified. Their serum PLA2R-Ab and renal PLA2R-Ag expression levels were determined, and the clinical correlations between these parameters and clinical features were examined.
The sensitivities of serum PLA2R-Ab and renal PLA2R-Ag for diagnosing IMN were 74.2% and 88.2%, respectively ( < 0.001), with poor consistency. Higher serum PLA2R-Ab levels were correlated to stronger renal PLA2R-Ag expression ( = 0.048). Patients with positive PLA2R-Ab significantly differed from those with negative levels, in terms of proteinuric levels over 24 hours (4.54 3.46 g/day, = 0.015) and serum albumin (23.28 27.95 g/L, = 0.038). Among patients with positive renal PLA2R-Ag, patients with positive PLA2R-Ab had significantly higher 24-hour proteinuria, when compared to patients with negative PLA2R-Ab (4.57 3.08 g/day, = 0.005). Among those with positive PLA2R-Ab in sera, their PLA2R-Ab levels were correlated with the estimated glomerular filtration and serum creatinine.
Serum PLA2R-Ab exhibits a closer correlation with proteinuric severity and renal function, when compared to renal PLA2R-Ag.
M 型磷脂酶 A2 受体（PLA2R）是导致特发性膜性肾病（IMN）的首个自身抗原。然而，血清 PLA2R 抗体（PLA2R-Ab）在区分特发性膜性肾病和继发性膜性肾病方面可能不够准确，而肾 PLA2R 抗原（PLA2R-Ag）则成为辅助诊断。本研究旨在探讨特发性膜性肾病患者血清 PLA2R-Ab 与肾 PLA2R-Ag 之间的相关性。
回顾性分析 93 例特发性膜性肾病患者，检测其血清 PLA2R-Ab 和肾 PLA2R-Ag 表达水平，并分析这些参数与临床特征的相关性。
血清 PLA2R-Ab 和肾 PLA2R-Ag 诊断特发性膜性肾病的灵敏度分别为 74.2%和 88.2%（<0.001），一致性差。血清 PLA2R-Ab 水平越高，肾 PLA2R-Ag 表达越强（=0.048）。PLA2R-Ab 阳性患者与 PLA2R-Ab 阴性患者相比，24 小时蛋白尿（4.54±3.46 vs. 2.82±3.28，=0.015）和血清白蛋白（23.28±27.95 vs. 32.54±3.37，=0.038）水平差异有统计学意义。在肾 PLA2R-Ag 阳性患者中，PLA2R-Ab 阳性患者的 24 小时蛋白尿显著高于 PLA2R-Ab 阴性患者（4.57±3.08 vs. 2.82±3.28，=0.005）。在 PLA2R-Ab 阳性患者中，其 PLA2R-Ab 水平与估算肾小球滤过率和血清肌酐呈正相关。
与肾 PLA2R-Ag 相比，血清 PLA2R-Ab 与蛋白尿严重程度和肾功能的相关性更强。
