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Antiphospholipid Antibodies in Patients with Membranous Nephropathy
Qiankun Zhang1,2, Yaomin Wang1, Ying Xu1
1Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Institute of Nephrology, Zhejiang University, Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou, China.
Background/Aim:
The aim of this study was to investigate the prevalence and significance of antiphospholipid antibodies in patients with membranous nephropathy (MN).
Methods:
Patients hospitalized with MN during June 2015 to June 2017 were selected and patients with minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS) in the same period were selected as controls.
Results:
Overall, 267 patients with MN and 131 patients with MCD/FSGS (n = 101 MCD and n = 30 FSGS) were analyzed. There was a significant difference in the detection rate of anti-β2-glycoprotein I (anti-β2-GPI) antibodies (11.9% in MN vs. 4.5% in MCD/FSGS, p = 0.018) and IgG-anti-β2-GPI antibodies (3.7% in MN vs. 0% in MCD/FSGS, p = 0.034) between the 2 groups. Anti-β2-GPI antibody-positive MN patients (n = 32) had a lower serum C4 level than anti-β2-GPI antibody-negative MN patients (n = 235; 21.6 ± 7.6 vs. 24.6 ± 7.1 mg/dL, p = 0.030). Anti-β2-GPI antibody-positive MN patients had significant improvement of serum creatinine compared to anti-β2-GPI antibody-negative patients after 24 weeks of treatment (p = 0.006).
Conclusions:
Anti-β2-GPI antibody may play a role in the progression of MN, and this process might involve classic complement activation.
Insights
Antiphospholipid antibodies, specifically anti-β2-glycoprotein I (anti-β2-GPI), are more prevalent in membranous nephropathy (MN) patients. Anti-β2-GPI positivity in MN patients correlates with improved creatinine levels after treatment, suggesting a role in disease progression.
Area of Science:
- Nephrology
- Immunology
- Clinical Medicine
Background:
- Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults.
- The role of antiphospholipid antibodies in MN pathogenesis remains incompletely understood.
Purpose of the Study:
- To investigate the prevalence and clinical significance of antiphospholipid antibodies in patients diagnosed with membranous nephropathy (MN).
- To compare antibody levels between MN patients and controls with minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS).
Main Methods:
- Retrospective analysis of 267 MN patients and 131 MCD/FSGS control patients hospitalized between June 2015 and June 2017.
- Detection rates of anti-β2-glycoprotein I (anti-β2-GPI) and IgG-anti-β2-GPI antibodies were compared between groups.
- Clinical parameters, including serum C4 levels and serum creatinine, were analyzed in relation to antibody status.
Main Results:
- A significantly higher detection rate of anti-β2-GPI antibodies was observed in MN patients (11.9%) compared to controls (4.5%).
- MN patients positive for anti-β2-GPI antibodies exhibited lower serum C4 levels and demonstrated significant improvement in serum creatinine after 24 weeks of treatment.
- IgG-anti-β2-GPI antibodies were also found more frequently in MN patients.
Conclusions:
- Anti-β2-glycoprotein I antibodies may contribute to the progression of membranous nephropathy.
- The mechanism may involve the activation of the classical complement pathway.
- Identifying anti-β2-GPI antibodies could aid in predicting treatment response in MN patients.
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