title: Detection of anti-PLA2R autoantibodies and IgG subclasses in post-allogeneic hematopoietic stem cell transplantation membranous nephropathy.
abstract: BACKGROUND
  Membranous nephropathy (MN) is the most common glomerular disease of post-allogeneic hematopoietic stem cell transplantation (HSCT). Although this condition is now considered a renal complication of chronic graft-versus-host disease (cGVHD), the pathogenesis of this disease is not well established.
  
  
  METHODS
  Five patients with post-HSCT MN diagnosed by renal biopsy were selected for this study. The clinical and renal pathological data of these patients were analyzed, and anti-PLA2R (M-type phospholipase A2 receptor) autoantibodies and IgG subclasses were detected in the serum samples from the patients.
  
  
  RESULTS
  None of the 5 patients had a history of kidney disease. All the patients had a combination of cGVHD and proteinuria, which was in remission after an effective anti-graft-versus-host disease treatment. The immunofluorescent detection showed that IgG4 was the predominant IgG subclass, and the distribution of IgG4 was the same as that of nephrin. The anti-PLA2R autoantibodies were negative in 4 patients and positive in 1 patient. The levels of IgG2, IgG3 and IgG4 increased in the majority of the patients.
  
  
  CONCLUSIONS
  Our data showed that the clinical course of post-HSCT MN patients was closely related to that of cGVHD. Although the renal pathology was similar to idiopathic MN, the negative result for the anti-PLA2R autoantibodies in the majority of the patients suggested that the formation of an immune complex occurs differently between these 2 diseases.
authors.affiliation: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Huang
authors.forename: Weisong
authors.initials: W
authors.lastname: Qin
authors.forename: Mingchao
authors.initials: M
authors.lastname: Zhang
authors.forename: Chunxia
authors.initials: C
authors.lastname: Zheng
authors.forename: Caihong
authors.initials: C
authors.lastname: Zeng
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015153:Blotting, Western; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000097:blood / Q000276:immunology*; D057809:HEK293 Cells; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D054507:Receptors, Phospholipase A2 / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; D054507:Receptors, Phospholipase A2