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Serum secretory phospholipase A2 group IB correlates with the severity of membranous nephropathy
Weihao Li1, Mingming Zhang2, Yaping Guo3
1Department of Laboratory Medicine, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Background:
Serum secretory phospholipase A2 group IB (sPLA2-IB) is involved in the pathological processes of membranous nephropathy (MN). To date, there is no large-scale study validating the usefulness of circulating sPLA2-IB in the follow-up of patients with MN. This study investigated the role of circulating sPLA2-IB in the evaluation of severity of MN.
Methods:
A total of 158 patients with primary membranous nephropathy (pMN), 34 with secondary membranous nephropathy (sMN) and 53 healthy controls were enrolled. Histological staging was made for all MN patients. 36 of the pMN patients accepted immunosuppressive therapy and 11 sMN patients who received treatment of primary disease were followed up for 6 months. Serum group IB secretory phospholipase A2 (sPLA2-IB), M-type phospholipase A2 receptor antibody (PLA2R-Ab), blood urea nitrogen, creatinine, total protein, albumin, cholesterol, triglyceride and 24-hour urine protein were measured at the time of diagnosis. SPLA2-IB and 24-hour urine protein were measured at the end of follow-up.
Results:
Circulating sPLA2-IB levels were significantly higher in pMN and sMN patients compared to controls and negatively correlated with TP and albumin, whereas positively correlated with 24-hour urine protein. PLA2-IB was found increased with the severity of proteinuria when divided MN patiens into three groups according to degree of proteinuria. Through the 6-month follow-up, sPLA2-IB and 24 h-urine protein levels were found significantly decreased when patients with pMN or sMN reached remission. By ROC analysis, PLA2R-Ab was demonstrated to be most significant in the differential diagnosis of pMN and sMN compared with 24-hour urinary protein and serum sPLA2-IB.
Conclusion:
Despite the limited significance to differentiate pMN from sMN, sPLA2-IB was correlated with the level of proteinuria in MN patients suggesting to be a potential biomarker for monitoring disease severity and therapeutic effects of both pMN and sMN.
Insights
Serum secretory phospholipase A2 group IB (sPLA2-IB) may help monitor membranous nephropathy (MN) severity. Higher sPLA2-IB levels correlated with worse proteinuria, decreasing with treatment, suggesting its potential as a biomarker for MN patients.
Area of Science:
- Nephrology
- Immunology
- Biochemistry
Background:
- Serum secretory phospholipase A2 group IB (sPLA2-IB) plays a role in membranous nephropathy (MN) pathogenesis.
- No large-scale studies have validated sPLA2-IB for MN patient follow-up.
- This study aimed to evaluate circulating sPLA2-IB in assessing MN severity.
Purpose of the Study:
- To investigate the role of circulating sPLA2-IB in evaluating the severity of membranous nephropathy (MN).
- To assess the correlation between sPLA2-IB levels and proteinuria in MN patients.
- To determine if sPLA2-IB can serve as a biomarker for monitoring disease progression and treatment response in MN.
Main Methods:
- 158 primary MN (pMN), 34 secondary MN (sMN) patients, and 53 controls were enrolled.
- Serum sPLA2-IB, PLA2R-Ab, and proteinuria were measured at diagnosis and after 6 months of follow-up.
- Histological staging and ROC analysis were performed.
Main Results:
- sPLA2-IB levels were significantly higher in MN patients compared to controls.
- sPLA2-IB positively correlated with 24-hour urine protein and negatively with total protein and albumin.
- sPLA2-IB levels decreased significantly upon remission in pMN and sMN patients.
Conclusions:
- sPLA2-IB correlates with proteinuria levels in MN patients.
- sPLA2-IB shows potential as a biomarker for monitoring MN disease severity.
- sPLA2-IB may help track therapeutic effects in both pMN and sMN.
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