Clinical usefulness of anti-M-type phospholipase-A-receptor antibodies in patients with membranous nephropathy and the comparison of three quantification methods. Issue 1 (2nd January 2020)

• Record Type: Journal Article
• Authors: Katsumata, Yasuhiro; Okamoto, Yuko; Moriyama, Takahito; Moriyama, Rina; Kawamoto, Manabu; Hanaoka, Masanori; Uchida, Keiko; Nitta, Kosaku; Harigai, Masayoshi
• Is Part Of: Immunological medicine. Volume 43:Issue 1(2020)
• Page Start: 47
• Page End: 56
• Publication Date: 2020-01-02
• Subjects: Autoantibodies -- biomarkers -- membranous nephropathy -- systemic lupus erythematosus; Immune System Phenomena; Immune System Diseases; Immunology -- Periodicals; Immunology; Periodical; Periodicals; Electronic journals; 571.96
• DOI: 10.1080/25785826.2019.1710079
• Languages: English
• ISSNs: 2578-5826

Abstract

Abstract: Associations between anti-M-type phospholipase A2 receptor (PLA2R) antibodies and disease activity and prognosis have been suggested in primary membranous nephropathy (MN); however, more evidence is needed. We aimed to establish a clinically useful method to measure anti-PLA2R antibodies. We developed a western blot assay and a cell-based enzyme-linked immunosorbent assay (ELISA). Anti-PLA2R antibodies were evaluated retrospectively using these assays and the commercial solid-phase ELISA. Anti-PLA2R antibodies were detected in 12, 6, and 12 out of 23 Japanese patients with biopsy-proven primary MN using the western blot, the cell-based ELISA, and the solid-phase ELISA, respectively. The samples of the lupus MN patients tested negative. The levels of proteinuria correlated moderately with the titres of anti-PLA2R antibodies measured by the three methods ( r = 0.39–0.47). Anti-PLA2R antibodies were significantly associated with physicians' decisions on immunosuppressive treatment without prior knowledge of anti-PLA2R antibody positivity ( p < .01). In the longitudinal analysis, the titres of anti-PLA2R antibodies measured by the solid-phase ELISA declined significantly following treatment ( p = .03). In conclusion, these results suggest the usefulness of anti-PLA2R antibody as a diagnostic, prognostic, and surrogate biomarker in primary MN. The three methods proved to be reliable for measuring anti-PLA2R antibody titres, but their performances differ.