Antiphospholipase A2 receptor antibody titer and subclass in idiopathic membranous nephropathy. - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles Journal of the American Society of Nephrology Year : 2012

Antiphospholipase A2 receptor antibody titer and subclass in idiopathic membranous nephropathy.

Abstract

The phospholipase A(2) receptor (PLA(2)R) is the major target antigen in idiopathic membranous nephropathy. The technique for measuring antibodies against PLA(2)R and the relationship between antibody titer and clinical characteristics are not well established. Here, we measured anti-PLA(2)R (aPLA(2)R) antibody titer and subclass in a well defined cohort of 117 Caucasian patients with idiopathic membranous nephropathy and nephrotic-range proteinuria using both indirect immunofluorescence testing (IIFT) and ELISA. We assessed agreement between tests and correlated antibody titer with clinical baseline parameters and outcome. In this cohort, aPLA(2)R antibodies were positive in 74% and 72% of patients using IIFT and ELISA, respectively. Concordance between both tests was excellent (94% agreement, κ=0.85). Among 82 aPLA(2)R-positive patients, antibody titer significantly correlated with baseline proteinuria (P=0.02). Spontaneous remissions occurred significantly less frequently among patients with high antibody titers (38% versus 4% in the lowest and highest tertiles, respectively; P<0.01). IgG4 was the dominant subclass in the majority of patients. Titers of IgG4, but not IgG1 or IgG3, significantly correlated with the occurrence of spontaneous remission (P=0.03). In summary, these data show high agreement between IIFT and ELISA assessments of aPLA(2)R antibody titer and highlight the pathogenetic role of these antibodies, especially the IgG4 subclass, given the observed relationships between aPLA(2)R titer, baseline proteinuria, and outcome.
Embargoed file
Embargoed file
Visibility date is undetermined
Loading...

Dates and versions

inserm-00919117 , version 1 (16-12-2013)

Identifiers

Cite

Julia M. Hofstra, Hanna Debiec, Colin D. Short, Timotheé Pellé, Robert Kleta, et al.. Antiphospholipase A2 receptor antibody titer and subclass in idiopathic membranous nephropathy.. Journal of the American Society of Nephrology, 2012, 23 (10), pp.1735-43. ⟨10.1681/ASN.2012030242⟩. ⟨inserm-00919117⟩
161 View
2 Download

Altmetric

Share

Gmail Facebook X LinkedIn More