Research Papers: Immunology:
Biomarkers to detect membranous nephropathy in Chinese patients
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Li Lin1, Wei Ming Wang1, Xiao Xia Pan1, Jing Xu1, Chen Ni Gao1, Wen Zhang1, Hong Ren1, Jing Yuan Xie1, Pin Yan Shen1, Yao Wen Xu1, Li Yan Ni1 and Nan Chen
1 Department of Nephrology, Institute of Nephrology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
Nan Chen, email:
Keywords: chronic kidney disease, PLA2R, retinol binding protein, THSD7A, membranous nephropathy, Immunology and Microbiology Section, Immune response, Immunity
Received: June 17, 2016 Accepted: September 05, 2016 Published: September 13, 2016
Anti-M-type phospholipase A2 receptor (anti-PLA2R) is a widely accepted biomarker for clinical idiopathic membranous neurophathy (IMN). However, its ability to differentiate between IMN and secondary MN (SMN) is controversial. The objective of this study was to assess clinical MN biomarkers in blood, tissue and urine samples from Chinese patients. In total, 195 MN patients and 70 patients with other glomerular diseases were prospectively enrolled in the study. Participants were followed up for average of 17 months (range 3-39 months). Anti-PLA2R and anti-THSD7A (thrombospondin type-1 domain-containing 7A) were detected only in MN patient sera and not in controls. Serum anti-THSD7A and THSD7A-positive biopsies were detected in 1/18 and 2/18 PLA2R-negative MN cases, respectively. PLA2R and THSD7A were detected in 72.27% and 40% of SMN cases, respectively. While serum positivity for both anti-PLA2R and anti-THSD7A at the time of renal biopsy was specific to MN patients, neither antigen could discriminate between primary and secondary MN. We also found that high urinary levels of retinol binding protein (RBP) predicted poor proteinuria outcomes in study participants. Patients with low or medium urinary RBP levels achieved remission more frequently than those with high RBP.
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