The Prognostic Value of Anti-PLA2R Antibodies Levels in Primary Membranous Nephropathy

• Published in: International journal of molecular sciences 2023-05, Vol.24 (10), p.9051
• Main Authors: Kukuy, Olga Lesya, Cohen, Ron, Gilburd, Boris, Zeruya, Eleanor, Weinstein, Talia, Agur, Timna, Dinour, Dganit, Beckerman, Pazit, Volkov, Alexander, Nissan, Johnatan, Davidson, Tima, Amital, Howard, Shoenfeld, Yehuda, Shovman, Ora
• Format: Article
• Language: English
• Subjects: Albumin; Analysis; Antibodies; Autoantibodies; Biomarkers; Biopsy; Communication; Creatinine; Development and progression; Diagnosis; Disease; Edema; Enzyme-linked immunosorbent assay; Ethnicity; Female; Glomerulonephritis, Membranous - diagnosis; Humans; Hypertension; Hypoalbuminemia; Kidney diseases; Laboratories; Male; Medical equipment and supplies industry; Medical test kit industry; Membranous nephropathy; Nephropathy; Patients; Permutations; Prognosis; Proteinuria; Proteinuria - drug therapy; Remission; Remission (Medicine); Serum albumin; Statistical analysis; Viral antibodies
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms24109051

Anti-PLA2R antibodies (Ab) are a diagnostic and prognostic biomarker in primary membranous nephropathy (PMN). We assessed the relationship between the levels of anti-PLA2R Ab at diagnosis and different variables related to disease activity and prognosis in a western population of PMN patients. Forty-one patients with positive anti-PLA2R Ab from three nephrology departments in Israel were enrolled. Clinical and laboratory data were collected at diagnosis and after one year of follow-up, including serum anti-PLA2R Ab levels (ELISA) and glomerular PLA2R deposits on biopsy. Univariable statistical analysis and permutation-based ANOVA and ANCOVA tests were performed. The median [(interquartile range (IQR)) age of the patients was 63 [50-71], with 28 (68%) males. At the time of diagnosis, 38 (93%) of the patients had nephrotic range proteinuria, and 19 (46%) had heavy proteinuria (≥8 gr/24 h). The median [IQR] level of anti-PLA2R at diagnosis was 78 [35-183] RU/mL. Anti-PLA2R levels at diagnosis were correlated with 24 h proteinuria, hypoalbuminemia and remission after one year ( = 0.017, = 0.003 and = 0.034, respectively). The correlations for 24 h proteinuria and hypoalbuminemia remained significant after adjustment for immunosuppressive treatment ( = 0.003 and = 0.034, respectively). Higher levels of anti-PLA2R Ab at diagnosis in patients with active PMN from a western population are associated with higher proteinuria, lower serum albumin and remission one year after the diagnosis. This finding supports the prognostic value of anti-PLA2R Ab levels and their possible use in stratifying PMN patients.