Antiphospholipase A2 receptor antibody titer and subclass in idiopathic membranous nephropathy

Julia M Hofstra, Hanna Debiec, Colin D Short, Timotheé Pellé, Robert Kleta, Peter W Mathieson, Pierre Ronco, Paul E Brenchley, Jack F Wetzels

Research output: Contribution to journalArticle (Academic Journal)

188 Citations (Scopus)

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
Original languageEnglish
Pages (from-to)1735-1743
Number of pages9
JournalJournal of the American Society of Nephrology
Volume23
Issue number10
DOIs
Publication statusPublished - 28 Sep 2012

Keywords

  • Renal Insufficiency
  • Fluorescent Antibody Technique, Indirect
  • Humans
  • Prognosis
  • Aged
  • Glomerulonephritis, Membranous
  • Receptors, Phospholipase A2
  • Remission, Spontaneous
  • Proteinuria
  • Autoantibodies
  • Adult
  • Cohort Studies
  • Immunoglobulin G
  • Enzyme-Linked Immunosorbent Assay
  • Middle Aged
  • Female
  • Male

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  • Cite this

    Hofstra, J. M., Debiec, H., Short, C. D., Pellé, T., Kleta, R., Mathieson, P. W., Ronco, P., Brenchley, P. E., & Wetzels, J. F. (2012). Antiphospholipase A2 receptor antibody titer and subclass in idiopathic membranous nephropathy. Journal of the American Society of Nephrology, 23(10), 1735-1743. https://doi.org/10.1681/ASN.2012030242