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Nefrologia clinica

ANTI- M-TYPE PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ANTIBODIES IN IDIOPATHIC MEMBRANOUS NEPHROPATHY (IMN): DIAGNOSTIC AND CLINICAL SIGNIFICANCE

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Abstract

Background. IMN is the main cause of nephrotic syndrome in adults. Although this condition may spontaneously go into remission, a significant number of patients (up to 40%) progress to end stage renal disease (ESDR). Outcome predictors as well as prognostic biomarkers which could help to identify response to immunosuppressive treatment would be of utmost usefulness. Recently, an important role for autoantibodies recognizing podocytes antigens has been suggested. Different podocyte proteins have been reported as the target of the immune response in IMN. Among them anti-PLA2r antibodies seem to play a major role, being present in 52-78% of cases.

Aims. To assess the prevalence of anti-PLA2r antibodies in a large cohort of IMN and glomerular disease controls and to correlate their presence and titre with clinical parameters.

Patients and Method: 100 IMN, 30 non-membranous primary GN, 48 secondary GN, and 43 healthy controls.Indirect Immunofluorescence Technique using HEK293 cells transfected with the specific c-DNA as substrate (anti-PLA2r IIFT, Euroimmun).

Results. Anti-PLA2r were present in 69/100 IMN pts but only in 2/78 glomerular disease controls; all healthy were negative.

Conclusions. anti-PLA2r are present in about two-thirds of IMN sera, but only occasionally found in non-membranous primary GN or secondary GN. Such high prevalence and specificity suggest a pathogenetic role of such autoantibodies, and strongly support the diagnostic usefulness of the novel anti-PLA2r assay. Correlations between anti-PLA2r and clinical parameters is ongoing.

A. Radice(1), L. Bianchi(1), C. Murtas(2), G. Ghiggeri(2), S. Glionna(1), T. Stellato(3), R. Magistroni(4), G. Moroni(5), L. Allegri(6), L. Gesualdo(7), R.A. Sinico(1)
((1)San Carlo Borromeo Hospital Milano , (2)G. Gaslini Hospital Genova , (3)San Gerardo Hospital Monza , (4)Modena And Reggio Emilia University , (5)Ospedale Maggiore-policlinico Milano , (6)Parma University , (7)Bari University )
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Realizzazione: Tesi S.p.A.

Per assistenza contattare: Claudia Ingrassia, Tesi S.p.A.
0172 476301 — claudia.ingrassia@gruppotesi.com