ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2013;2(4):241-248.
doi:10.12860/JNP.2013.38
PMID: 24475456
PMCID: PMC3891130

Scopus id: 84881177076

Original Article

Anti-phospholipase A2 receptor antibody in idiopathic membranous nephropathy: A report from Iranian population

*Corresponding author:Prof. MohammadRezaArdalan: Drug applied research center, and chronic kidney disease research center. Tabriz University of Medical Sciences, Tabriz, Iran. Tel/ Fax: +98 411 3373966, Email: ardalan34@yahoo.com.

Abstract

Background: Idiopathic Membranous Nephropathy (iMN) is the most common cause of nephrotic syndrome in adults. Approximately one third of patients with iMN progress to end-stage renal disease. Anti-phospholipase A2-receptor (anti-PLA2R) antibodies are present in patients with iMN and appear to play a role in the pathogenesis of iMN.

Objectives: In this study, we explored the prevalence of anti-PLA2R antibodies in a cohort of patients with iMN in Iran. We also sought to determine circulating levels of anti-secretory PLA2 (anti-sPLA2) antibodies in those with anti-PLA2R antibodies.

Patients and Methods: Using an indirect immunofluorescence assay, we measured anti-PLA2R antibodies in a group of patients with iMN in Iran. The serum levels of anti-sPLA2 antibodies were also measured in those with positive results for anti-PLA2R antibodies.

Results: We studied 23 patients with iMN (M/F 12/11, 34±9.8 year), two patients with secondary MN and five patients with the nephrotic syndrome of other causes.Anti-PLA2R antibodies were detected in 17/23 (74%) of patients with iMN, but not in those with secondary MN or other forms of primary glomerular diseases. We found no correlation between anti-PLA2R antibody titer and the degree of proteinuria. We found high titers of anti-sPLA2 antibodies in a subset of patients with high levels of anti-PLA2R antibodies.

Conclusions: Anti-PLA2R antibodies are specific for iMN. Proteinuria may also reflect glomerular structural damage rather than immunological activity of the disease. The preliminary idea of any presumptive role of anti-sPLA2antibodies in iMN needs further investigation.

Implication for health policy/practice/research/medical education:

Idiopathic membranous nephropathy should no longer be considered “idiopathic”. Anti phospholipase A2-receptor (anti-PLA2R) antibodies are a useful method for its diagnosis. However, more studies are needed to confirm its presence in different population and exploring its mechanisms of action in the pathogenesis of idiopathic membranous nephropathy.

Please cite this paper as: Ardalan MR, Ghafari A, Hamzavi F, Nasri H, Baradaran B, Majidi J, Nikbin B.Antiphospholipase A2 receptor antibody in idiopathic membranous nephropathy: A report from Iranian population. J Nephropathology. 2013; 2(4): 241-248, DOI: 10.12860/JNP.2013.38

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