Related Experiment Video
Updated: Jun 11, 2026

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Serum anti-PLA2R negativity does not exclude glomerular PLA2R expression in primary membranous nephropathy
Şenay Yıldırım1, Ayça İnci2, Ayşe Karaduru Avcı3
1Department of Pathology, Antalya Training and Research Hospital, Antalya, Türkiye.
None:
Primary membranous nephropathy (pMN) is a principal cause of nephrotic syndrome in adults. The identification of the M-type phospholipase A2 receptor (PLA2R) antigen has significantly advanced non-invasive management; however, the precise clinical relationship between circulating antibody titers and intrarenal antigen deposition continues to be debated. This single-center retrospective study sought to analyze the correlation between clinicopathological parameters, serum anti-PLA2R levels, and glomerular PLA2R tissue expression in pMN. A specific focus was placed on evaluating the diagnostic utility of tissue staining in seronegative patients. A cohort of 49 adult pMN patients, diagnosed via renal biopsy between 2018 and 2025, was evaluated. Serum anti-PLA2R antibodies were quantified using ELISA, while glomerular PLA2R expression and staining intensity (graded 0 to +3) were assessed via immunohistochemistry (IHC) on paraffin-embedded sections. The results demonstrated a notable discordance: the overall serum antibody positivity rate was 49.0%, yet tissue PLA2R expression was detected in 100% of the cohort, encompassing all seronegative cases. A statistically significant difference was observed in the distribution of tissue PLA2R staining intensity based on serum PLA2R status (p=0.002). Conversely, no statistically significant correlation was found between circulating antibody titers and baseline renal function or proteinuria markers (p>0.05). In conclusion, these findings indicate that negative serology does not preclude tissue PLA2R positivity, potentially attributable to mechanisms such as the "kidney-as-a-sink" phenomenon or persistent immunological footprints. This investigation underscores that serum and tissue PLA2R serve as complementary, rather than mutually exclusive, markers. Consequently, renal biopsy with supplementary IHC staining remains a crucial and clinically valuable diagnostic tool, particularly in seronegative cases.
More Related Videos
Related Concept Videos
Nephrotic Syndrome I : Introduction
Nephrotic Syndrome II : Assessment and Medical Management
Diabetic Nephropathy
Renal Corpuscle
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous capillaries...
Nephrons

