Analysis of tissue PLA2R efficacy in evaluating the prognosis of
idiopathic membranous nephropathy in the background of different serum
anti-PLA2R levels
Abstract
Objective To verify serum PLA2R antibody and glomerular PLA2R antigen
expression in membranous nephropathy as well as to explore their
relationship with clinical presentation and disease prognosis. Methods
We retrospectively analyzed 155 patients clinical figures who were
diagnosed with primary membranous nephropathy by kidney biopsy. Patients
were divided into 6 groups according to their serum PLA2R antibody or
glomerular PLA2R antigen positiveness and the level of serum PLA2R
antibody titer. Both clinical features and pathological characteristics
were recorded, and remission rate as well as time to response were
compared among groups. Correlation between clinical figures and titer of
PLA2R antibody or semi-quantity of PLA2R antigen were detected. Results
Among patients with positive serum PLA2R antibody and tissue PLA2R
antigen, higher baseline PLA2R antibody levels were associated with
lower remission rate and longer remission time. A positive correlation
between time to partial remission and serum PLA2R antibody titer was
found. Among patients with serum PLA2R antibody titer <150U/L,
there were shorter remission time in negative tissue PLA2R antigen group
compared with positive tissue PLA2R antigen, and a positive correlation
between time to complete remission and semi-quantity of tissue PLA2R
antigen was found. Conclusion Both glomerular PLA2R antigen and serum
PLA2R antibody play a role in disease presentation and prognosis in
primary membranous nephropathy. Glomerular PLA2R antigen has a major
role on disease prognosis when serum PLA2R antibody titer is less than
150U/L, while serum PLA2R antibody has predominant role in MN prognosis
when serum PLA2R antibody titer is above 150 U/L.