Serum Anti Pla۲r Antibody and Glomerular Pla۲r Deposition and their Association with Clinical Characteristics in Patients with Membranous Nephropathy

Introduction: Primary membranous nephropathy (PMN) is closely linked with autoantibodies targeting the M-type phospholipase A۲ receptor (PLA۲R) on podocytes. However, the association between circulating anti-PLA۲R antibodies and glomerular PLA۲R deposition and their correlation with clinical parameters remains to be studied. Methods: This hospital oriented cross-sectional observational research was accompanied on ۳۳ biopsy-proven PMN patients in a tertiary care hospital of North Karnataka, India, for ۱۸ months. Serum anti-PLA۲R antibody levels were evaluated through immunosorbent assay, and deposition of glomerular PLA۲R antigen was determined via immunofluorescence. Clinical parameters included renal function tests, serum proteins, and urine protein-creatinine ratio. Results: Of the ۳۳ subjects with PMN confirmed by biopsy, ۲۵ (۷۵.۷۶%) had positive anti-PLA۲R antibodies in their blood with a median titer of ۱۰۱ RU/mL, whereas glomerular PLA۲R deposits were found in ۲۹ patients (۸۷.۸۸%). According to renal biopsy data, the glomerular PLA۲R deposits exhibited good diagnostic performance. Statistically significant but modest inverse correlation existed between the serum anti-PLA۲R antibody titers and serum protein concentration (r = -۰.۴۵, P-value= ۰.۰۰۸). No statistically significant relationship was established between the antibody titers and edema duration, age, or gender. Conclusion: Serum anti-PLA۲R antibodies, glomerular PLA۲R deposition, and serum protein levels are closely related in patients with PMN. Glomerular PLA۲R antigen deposition is a highly sensitive and accurate predictor of PMN. Serum anti-PLA۲R antibodies seem to be a more reliable marker of disease activity than glomerular PLA۲R deposition, although future researches with larger sample sizes are needed to authenticate the finding.

کلیدواژه ها:

PLA۲R deposition ، Primary membranous nephropathy ، Serum anti phospholipase A۲ receptor ، Biomarkers ، Podocytes ، Proteinuria ، disease activity