title: Evaluation of anti-PLA2R1 as measured by a novel ELISA in patients with idiopathic membranous nephropathy: a cohort study.
abstract: OBJECTIVE
  Autoantibodies against the M-type phospholipase A2 receptor 1 (anti-PLA2R1) have been demonstrated to be very specific for idiopathic membranous nephropathy (MN). We studied a novel enzyme-linked immunosorbent assay (ELISA) and compared results with results obtained using an indirect immunofluorescence (IIF) and a Western blotting test (WB).
  
  
  METHODS
  One-hundred nine patients with idiopathic MN were recruited between November 1979 and March 2011. The control cohort comprised serum samples from patients with secondary MN (n = 16) and nephrotic controls (n = 17). The presence of anti-PLA2R1 in serum samples obtained at the time of renal biopsy was determined using ELISA, IIF, and WB.
  
  
  RESULTS
  With similar specificity (≥ 97%), sensitivity varied from 68% (IIF) to 72% (ELISA, WB). Remarkably, patients who were seronegative for anti-PLA2R1 more often entered spontaneous remission (P = .038), whereas seropositive patients were more frequently treated with immunosuppressive agents (P < .001).
  
  
  CONCLUSIONS
  ELISA performs excellently in differentiating idiopathic from secondary MN. Furthermore, ELISA shared high agreement with WB and IIF.
authors.affiliation: From Maastricht University.
authors.forename: Sjoerd A M E G
authors.initials: SA
authors.lastname: Timmermans
authors.affiliation: Central Diagnostic Laboratory, and.
authors.forename: Jan G M C
authors.initials: JG
authors.lastname: Damoiseaux
authors.affiliation: Central Diagnostic Laboratory, and.
authors.forename: Petra T J
authors.initials: PT
authors.lastname: Heerings-Rewinkel
authors.affiliation: Renal Section and Department of Medicine, Boston University Medical Center, Boston, MA; and.
authors.forename: Rivka
authors.initials: R
authors.lastname: Ayalon
authors.affiliation: Renal Section and Department of Medicine, Boston University Medical Center, Boston, MA; and.
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Beck
authors.affiliation: EUROIMMUN AG, Lübeck, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schlumberger
authors.affiliation: Renal Section and Department of Medicine, Boston University Medical Center, Boston, MA; and.
authors.forename: David J
authors.initials: DJ
authors.lastname: Salant
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands;
authors.forename: Pieter
authors.initials: P
authors.lastname: van Paassen
authors.affiliation: From Maastricht University, jw.cohentervaert@maastrichtuniversity.nl.
authors.forename: Jan Willem Cohen
authors.initials: JW
authors.lastname: Tervaert
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D054507:Receptors, Phospholipase A2 / Q000276:immunology*; D012680:Sensitivity and Specificity
chemical_list: D001323:Autoantibodies; C516360:PLA2R1 protein, human; D054507:Receptors, Phospholipase A2
keywords: ELISA; Membranous nephropathy; Nephrotic syndrome; Phospholipase A2 receptor 1; Sensitivity and specificity