Autoantibodies Specific for the Phospholipase A(2) Receptor in Recurrent and De Novo Membranous Nephropathy

作者:Debiec H*; Martin L; Jouanneau C; Dautin G; Mesnard L; Rondeau E; Mousson C; Ronco P
来源:American Journal of Transplantation, 2011, 11(10): 2144-2152.
DOI:10.1111/j.1600-6143.2011.03643.x

摘要

Recent findings in idiopathic membranous nephropathy (MN) suggest that in most patients, the disease is because of anti-phospholipase A(2) receptor (PLA(2)R1) autoantibodies. Our aim was to analyze the prevalence and significance of anti-PLA(2)R1 antibodies in recurrent and de novo MN after transplantation. We assessed circulating PLA(2)R1 autoantibodies by a direct immunofluorescence assay based on human embryonic kidney cells transfected with a PLA(2)R1 cDNA, and the presence of PLA(2)R1 antigen in immune deposits. We showed that PLA(2)R1 was involved in 5 of 10 patients with recurrent MN, but in none of the 9 patients with de novo MN. We also showed a marked heterogeneity in the kinetics and titers of anti-PLA(2)R1, which may relate to different pathogenic potential. We provide evidence that some patients with PLA(2)R1-related idiopathic MN and anti-PLA(2)R1 antibodies at the time of transplantation will not develop recurrence. Because PLA(2)R1 autoantibody was not always associated with recurrence, its predictive value should be carefully analyzed in prospective studies.

  • 出版日期2011-10