Related Experiment Video
Updated: Mar 22, 2026
Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
Published on: August 23, 2024
Serum Anti-PLA2R Antibody Predicts Treatment Outcome in Idiopathic Membranous Nephropathy
Shi-Yao Wei1, Yu-Xiao Wang, Jian-Si Li
1Department of Nephrology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, PR China.
Background:
M-type phospholipase A2 receptor (PLA2R) has been identified as the major target antigen in idiopathic membranous nephropathy (IMN). However, the role of glomerular PLA2R (gPLA2R) and the associations of serum anti-PLA2R antibody (sPLA2R-Ab) titre with diagnosis, treatment and prognosis in IMN need to be further investigated.
Methods:
We screened 148 consecutive patients with biopsy-proven membranous nephropathy (MN; 113 with IMN and 35 with secondary MN (SMN)) who were followed up for ≤20 months. Serum and urine samples were simultaneously collected at different time points. The levels of sPLA2R-Ab were detected using immunofluorescence and enzyme-linked immunosorbent assay. gPLA2R was assessed by immunofluorescence.
Results:
Most patients with IMN displayed both gPLA2R and sPLA2R-Ab positive (85.8 and 82.3%, respectively). In contrast, very few patients with SMN showed either gPLA2R or sPLA2R-Ab positive. The sPLA2R-Ab titre, not gPLA2R, was significantly correlated with proteinuria. Surprisingly, changes in sPLA2R-Ab titre occurred earlier and faster than proteinuria in patients who were followed up for ≤20 months during the whole period of observation. Survival analysis of IMN patients indicated a significant association between sPLA2R-Ab titre and outcome, whereas, no significant difference was observed between the gPLA2R intensity and outcome.
Conclusions:
These data indicate that sPLA2R-Ab might be a better biomarker for IMN diagnosis and treatment outcome. In addition, monitoring sPLA2R-Ab titre may assist in determining when to initiate the administration of immunosuppressive agents and in evaluating treatment efficacy.
Insights
Serum anti-PLA2R antibody (sPLA2R-Ab) titre is a better biomarker for diagnosing idiopathic membranous nephropathy (IMN) and predicting treatment outcomes than glomerular PLA2R (gPLA2R). Monitoring sPLA2R-Ab aids in treatment decisions and efficacy evaluation.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- Idiopathic membranous nephropathy (IMN) is characterized by the M-type phospholipase A2 receptor (PLA2R) as the primary target antigen.
- The clinical significance of glomerular PLA2R (gPLA2R) and serum anti-PLA2R antibody (sPLA2R-Ab) titre in IMN diagnosis, treatment, and prognosis requires further elucidation.
Purpose of the Study:
- To investigate the diagnostic and prognostic value of gPLA2R and sPLA2R-Ab titre in patients with membranous nephropathy (MN).
- To assess the correlation between sPLA2R-Ab titre, gPLA2R, and clinical parameters like proteinuria and treatment outcomes in IMN.
Main Methods:
- A cohort of 148 patients with biopsy-proven MN (113 IMN, 35 secondary MN) were analyzed.
- Serum and urine samples were collected, and sPLA2R-Ab levels were quantified using immunofluorescence and ELISA.
- gPLA2R expression was assessed via immunofluorescence.
Main Results:
- Most IMN patients tested positive for both gPLA2R (85.8%) and sPLA2R-Ab (82.3%), while secondary MN patients rarely showed positivity.
- sPLA2R-Ab titre, not gPLA2R, significantly correlated with proteinuria.
- Changes in sPLA2R-Ab titre preceded proteinuria changes, and sPLA2R-Ab titre was significantly associated with IMN patient outcomes, unlike gPLA2R intensity.
Conclusions:
- Serum anti-PLA2R antibody (sPLA2R-Ab) titre serves as a superior biomarker for IMN diagnosis and treatment outcome prediction.
- Monitoring sPLA2R-Ab levels can guide the initiation of immunosuppressive therapy and evaluate treatment effectiveness in IMN.
