title: Anti-phospholipase A2 receptor antibody in membranous nephropathy.
abstract: The M-type phospholipase A2 receptor (PLA2R) is a target autoantigen in adult idiopathic membranous nephropathy (MN), but the prevalence of autoantibodies against PLA2R is unknown among Chinese patients with MN. Here, we measured anti-PLA2R antibody in the serum of 60 patients with idiopathic MN, 20 with lupus-associated MN, 16 with hepatitis B (HBV)-associated MN, and 10 with tumor-associated MN. Among patients with idiopathic MN, 49 (82%) had detectable anti-PLA2R autoantibodies using a Western blot assay; an assay with greater sensitivity detected very low titers of anti-PLA2R in 10 of the remaining 11 patients. Using the standard assay, we detected anti-PLA2R antibody in only 1 patient with lupus, 1 with HBV, and 3 with cancer, producing an overall specificity of 89% in this cohort limited to patients with secondary MN. The enhanced assay detected low titers of anti-PLA2R in only 2 additional samples of HBV-associated MN. In summary, these results suggest that PLA2R is a major target antigen in Chinese idiopathic MN and that detection of anti-PLA2R is a sensitive test for idiopathic MN.
authors.affiliation: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Weisong
authors.initials: W
authors.lastname: Qin
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Beck
authors.forename: Caihong
authors.initials: C
authors.lastname: Zeng
authors.forename: Zhaohong
authors.initials: Z
authors.lastname: Chen
authors.forename: Shijun
authors.initials: S
authors.lastname: Li
authors.forename: Ke
authors.initials: K
authors.lastname: Zuo
authors.forename: David J
authors.initials: DJ
authors.lastname: Salant
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D016022:Case-Control Studies; D002681:China; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis* / Q000208:ethnology / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054507:Receptors, Phospholipase A2 / Q000276:immunology*; D012680:Sensitivity and Specificity
chemical_list: D000888:Antibodies, Anti-Idiotypic; D015415:Biomarkers; D054507:Receptors, Phospholipase A2