title: Prevalence of anti-phospholipase A2 receptor antibodies in Japanese patients with membranous nephropathy.
abstract: BACKGROUND
  Membranous nephropathy (MN) is the leading cause of nephrotic syndrome in adults. Anti-M-type phospholipase A2 receptor (anti-PLA2R) antibodies are found in most patients with idiopathic MN (iMN) worldwide, but the prevalence of anti-PLA2R antibodies among Japanese patients with MN is unknown. In this study, we determined the prevalence of anti-PLA2R antibodies in Japanese patients with MN.
  
  
  METHODS
  The study population of our retrospective cross-sectional consisted of 131 patients with biopsy-proven MN who had not received any immunosuppressive treatments at time of both renal biopsy and serum sample collection. Of these, 100 had iMN and 31 had secondary MN (sMN). The circulating anti-PLA2R antibodies were analyzed using a highly sensitive Western blot analysis. Analysis was performed under non-reducing conditions with a human glomerular extract at serum dilutions of 1:25, 1:10, and 1 as the primary antibody.
  
  
  RESULTS
  Anti-PLA2R antibodies were detected in 53 (53 %) of 100 patients with iMN and 0 (0 %) of 31 patients with sMN. The prevalence of anti-PLA2R antibodies was higher in patients with nephrotic syndrome (61 %) than in patients without nephrotic syndrome (43 %). The number of patients with serum albumin ≤ 3.0 g/dL was significantly higher in those with anti-PLA2R antibodies (92 %) than that in those without them (68 %).
  
  
  CONCLUSIONS
  Anti-PLA2R antibodies were found in Japanese patients with iMN; however, the prevalence was lower than that of any other Asian country. This may indicate that the presence of other pathogenic antigens plays a significant role in Japanese patients with iMN.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Shin'ichi
authors.initials: S
authors.lastname: Akiyama
authors.forename: Mari
authors.initials: M
authors.lastname: Akiyama
authors.forename: Enyu
authors.initials: E
authors.lastname: Imai
authors.forename: Takenori
authors.initials: T
authors.lastname: Ozaki
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
mesh_terms: D000368:Aged; D000906:Antibodies / Q000097:blood; D044466:Asian People; D015153:Blotting, Western; D003430:Cross-Sectional Studies; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000097:blood / Q000276:immunology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D054507:Receptors, Phospholipase A2 / Q000276:immunology*; D012189:Retrospective Studies
chemical_list: D000906:Antibodies; D054507:Receptors, Phospholipase A2