title: Autoantibodies against phospholipase A2 receptor in Korean patients with membranous nephropathy.
abstract: The data were presented in abstract form at the 45(th) meeting of the American Society of Nephrology, October 30-November 04 2012, San Diego, CA, USA. Circulating autoantibodies against M-type phospholipase A2 receptor (PLA2R) are important pathogenic antibodies of idiopathic membranous nephropathy (MN) in adults. However, previous studies on the clinical impact of anti-PLA2R antibodies demonstrated several limitations, including insufficient numbers of study subjects and different time points and methods for anti-PLA2R antibody measurement. To verify the clinical significance of anti-PLA2R antibodies in Korean patients with MN, we measured autoantibodies in serum samples obtained at the time of biopsy from a total of 100 patients with idiopathic MN who had not yet received immunosuppressive treatment. We detected anti-PLA2R antibody in 69 patients, and we observed that autoantibody reactivity reflected the severity of disease activity. Proteinuria and hypoalbuminemia were more severe in patients with anti-PLA2R than in those without the autoantibodies (2.95 g/g vs. 6.85 g/g, P = 0.003; 3.1 g/dL vs. 2.5 g/dL, P = 0.004, respectively). Additionally, the clinical severities worsened proportionally as the levels of anti-PLA2R antibodies increased (P = 0.015 and P for trend <0.001 for proteinuria and hypoalbuminemia, respectively). However, neither the levels nor the presence or absence of anti-PLA2R antibody showed a significant correlation with clinical outcomes, such as remission rate and time to remission. In conclusion, we observed that anti-PLA2R antibodies are highly prevalent in Korean patients with idiopathic MN and that they reflect the clinical disease activity before the administration of immunosuppressive treatment. However, the levels of anti-PLA2R antibody at the time of kidney biopsy may not predict the clinical outcomes in current clinical practice.
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors: Yun Jung
authors: YJ
authors: Oh
authors: Seung Hee
authors: SH
authors: Yang
authors: Dong Ki
authors: DK
authors: Kim
authors: Shin-Wook
authors: SW
authors: Kang
authors: Yon Su
authors: YS
authors: Kim
mesh_terms: D044466:Asian People; D001323:Autoantibodies / Q000097:blood*; D001706:Biopsy; D015153:Blotting, Western; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015433:Glomerulonephritis, Membranous / Q000097:blood* / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D054507:Receptors, Phospholipase A2 / Q000276:immunology*; D056910:Republic of Korea; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D054507:Receptors, Phospholipase A2
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