E Garcia-Vives1, C Solé1, T Moliné2, A M Alvarez-Rios1, M Vidal2, I Agraz3, J Ordi-Ros1, J Cortés-Hernández1. 1. 1 Department of Medicine, Systemic Autoimmune Diseases Unit, Hospital Universitari Vall d'Hebrón, Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain. 2. 2 Department of Renal Pathology, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain. 3. 3 Departament of Nephrology, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Spain.
Abstract
BACKGROUND: Antibodies to M-type phospholipase A2 receptor (a-PLA2R) have been identified in most patients with idiopathic membranous nephropathy, but the prevalence in membranous lupus nephritis (MLN) is still unclear. The objective of this study was to assess the prevalence of a-PLA2R antibodies in a large cohort of patients with lupus nephritis. METHODS: a-PLA2R antibodies were measured by ELISA in serum from patients with systemic lupus erythematosus ( n = 190), of whom 37 had a biopsy-proven MLN. Positive samples were confirmed by commercial ELISA kit, Western blot and immunohistochemistry in renal tissue. RESULTS: A total of 10 from 190 patients (5.3%) with systemic lupus erythematosus had circulating a-PLA2R measured by in-house ELISA assay. The antibodies were detected in 7 patients with MLN (18.9%) and 3 patients with non-renal lupus disease (3.2%). PLA2R staining was detected in the kidney biopsy of 5 of the 7 (71.4%) patients with MLN. a-PLA2R levels were associated with active disease but not proteinuria levels. Presence of a-PLA2R antibodies at baseline was associated with worse remission rates and longer time to remission compared to those patients serologically negative. CONCLUSIONS: a-PLA2R antibodies can be detected with low prevalence in MLN patients, but their detection is associated with a worse renal prognosis.
BACKGROUND: Antibodies to M-type phospholipase A2 receptor (a-PLA2R) have been identified in most patients with idiopathic membranous nephropathy, but the prevalence in membranous lupus nephritis (MLN) is still unclear. The objective of this study was to assess the prevalence of a-PLA2R antibodies in a large cohort of patients with lupus nephritis. METHODS: a-PLA2R antibodies were measured by ELISA in serum from patients with systemic lupus erythematosus ( n = 190), of whom 37 had a biopsy-proven MLN. Positive samples were confirmed by commercial ELISA kit, Western blot and immunohistochemistry in renal tissue. RESULTS: A total of 10 from 190 patients (5.3%) with systemic lupus erythematosus had circulating a-PLA2R measured by in-house ELISA assay. The antibodies were detected in 7 patients with MLN (18.9%) and 3 patients with non-renal lupus disease (3.2%). PLA2R staining was detected in the kidney biopsy of 5 of the 7 (71.4%) patients with MLN. a-PLA2R levels were associated with active disease but not proteinuria levels. Presence of a-PLA2R antibodies at baseline was associated with worse remission rates and longer time to remission compared to those patients serologically negative. CONCLUSIONS: a-PLA2R antibodies can be detected with low prevalence in MLN patients, but their detection is associated with a worse renal prognosis.
Authors: Bingileki F Lwezaula; Oluwatoyin I Ameh; Udeme E Ekrikpo; Francois Cj Botha; Ugochi S Okpechi-Samuel; Nicola Wearne; Pierre Ronco; Aminu K Bello; Ikechi G Okpechi Journal: BMC Nephrol Date: 2021-01-07 Impact factor: 2.388
Authors: David Campos Wanderley; Precil Diego Miranda de Menezes Neves; Lectícia Barbosa Jorge; Luiz Fernando Onuchic; Stanley Almeida Araujo Journal: Clin Kidney J Date: 2021-03-18