Medical University of Plovdiv, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 2021 Oct 31;63(5):692-696. doi: 10.3897/folmed.63.e55460.
Primary membranous nephropathy (PMN) is one of the most common causes of nephrotic syndrome in adults. The disease process is probably initiated by the binding of circulating autoantibodies to target podocyte antigens. In 2009, Beck et al. found that phospholipase A2 receptor (PLA2R1) was expressed on human podocytes in patients with PMN. Recent evidence suggests that PLA2R1 autoantibodies play an important role in the diagnosis of PMN.
The aim of the present study was to compare the serum levels of anti-PLA2R1 in patients with PMN, second MN (SMN), other nephropathies (ON), and healthy controls (HC).
The study included 52 patients with PMN, 12 patients with SMN, 49 patients with ON, and 50 healthy controls. The serum concentration of anti-PLA2R1 was determined with ELISA kit (Anti-PLA2R ELISA, IgG, EUROIMMUN, Lübeck, Germany) using MR-96A microplate Reader (MINDRAY). Statistical analysis was performed with SPSS v.22.0.
There was significant difference in the serum anti-PLA2R1 concentrations between patient groups and HC (p<0.0001). Compared to HC, the median anti-PLA2R1 level in the PMN group was significantly higher (4.8 RU/ml vs. 34.9 RU/ml, p=0.001), in the ON group it was lower (2.1 RU/ml, p=0.002) and did not differ in patients with SMN (2.9 RU/ml, p=0.193). The anti-PLA2R1 serum levels were significantly higher in the PMN group than in the SMN (p=0.015) and ON (p<0.001) groups.
Our results showed that anti-PLA2R1 is significantly increased in patients with PMN. We can conclude that the anti-PLA2R1 serum concentration may be used as a beneficial biomarker for distinguishing PMN from other membranous nephropathies.
原发性膜性肾病（PMN）是成人肾病综合征的最常见病因之一。疾病过程可能由循环自身抗体与靶足细胞抗原结合引发。2009 年，Beck 等人发现磷脂酶 A2 受体（PLA2R1）在患有 PMN 的患者的人足细胞上表达。最近的证据表明，PLA2R1 自身抗体在 PMN 的诊断中起重要作用。
本研究旨在比较 PMN、继发性膜性肾病（SMN）、其他肾病（ON）和健康对照组（HC）患者血清中抗-PLA2R1 的水平。
本研究纳入 52 例 PMN 患者、12 例 SMN 患者、49 例 ON 患者和 50 例健康对照者。使用 ELISA 试剂盒（抗-PLA2R ELISA，IgG，EUROIMMUN，吕贝克，德国）和 MR-96A 微孔板读数仪（MINDRAY）测定血清抗-PLA2R1 浓度。采用 SPSS v.22.0 进行统计学分析。
患者组与 HC 之间的血清抗-PLA2R1 浓度存在显著差异（p<0.0001）。与 HC 相比，PMN 组的中位数抗-PLA2R1 水平显著更高（4.8 RU/ml 比 34.9 RU/ml，p=0.001），ON 组更低（2.1 RU/ml，p=0.002），SMN 组无差异（2.9 RU/ml，p=0.193）。PMN 组的抗-PLA2R1 血清水平明显高于 SMN（p=0.015）和 ON（p<0.001）组。
我们的研究结果表明，PMN 患者的抗-PLA2R1 显著增加。我们可以得出结论，抗-PLA2R1 血清浓度可能作为区分 PMN 与其他膜性肾病的有益生物标志物。
