Profile of Indian Patients With Membranous Nephropathy.
ELISA
PLA2R
THSD7A
membranous nephropathy
thrombospondin
Journal
Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
03
05
2020
revised:
21
06
2020
accepted:
23
06
2020
entrez:
21
9
2020
pubmed:
22
9
2020
medline:
22
9
2020
Statut:
epublish
Résumé
The majority of primary membranous nephropathy (MN) cases are no longer considered idiopathic with the discovery of the podocytic autoantigens: phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain-containing 7A (THSD7A). Limited data on PLA2R-related MN in Indians exist in literature, and THSD7A-related MN remains undocumented in this population. We aimed to characterize the baseline PLA2R and THSD7A profile of adult and pediatric membranous nephropathy (MN) in a large Indian single-institution cohort. A retrospective analysis of all cases of MN (primary and secondary) between 2014 and 2017 was performed with PLA2R direct immunofluorescence and THSD7A immunohistochemistry on the biopsies and anti-PLA2R enzyme-linked immunosorbent assay (ELISA) on baseline sera. MN constituted 10% of kidney biopsies received in the study period. A total of 216 cases with adequate tissue underwent PLA2R direct immunofluorescence, and 110 of them had available sera for PLA2R ELISA. Combining both testing methods, the prevalence of PLA2R-related primary MN was 72.8%, with moderate concordance between the 2 methods (kappa 0.61). PLA2R was also detected in 16.7% cases of secondary MN, most commonly lupus MN. THSD7A immunohistochemistry performed on 176 cases showed a prevalence of 3.4% in primary MN. One case of lupus MN was also positive for THSD7A. Dual positivity (PLA2R and THSD7A) was noted in 2 cases. The large pediatric cohort tested showed a prevalence of 44% of PLA2R based on tissue testing, whereas 1 case demonstrated THSD7A positivity. This study in a large cohort of Indian patients demonstrates prevalence rates of PLA2R- and THSD7A-related MN similar to world literature, including the substantial cohort of pediatric MN. It also confirms variation in MN in the form of outliers within PLA2R (related to tissue and serum testing), dual positivity for PLA2R and THSD7A, and PLA2R/THSD7A-positive secondary MN.
Identifiants
pubmed: 32954080
doi: 10.1016/j.ekir.2020.06.024
pii: S2468-0249(20)31347-4
pmc: PMC7486174
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1551-1557Informations de copyright
© 2020 International Society of Nephrology. Published by Elsevier Inc.
Références
Ren Fail. 2018 Nov;40(1):306-313
pubmed: 29623759
Mod Pathol. 2013 May;26(5):709-15
pubmed: 23196797
Clin J Am Soc Nephrol. 2017 Jun 7;12(6):983-997
pubmed: 28550082
Pediatr Nephrol. 2018 Mar;33(3):463-472
pubmed: 29034405
J Am Soc Nephrol. 2019 Jun;30(6):1123-1136
pubmed: 31061139
J Am Soc Nephrol. 2017 Feb;28(2):520-531
pubmed: 27436855
Lupus. 2019 Mar;28(3):396-405
pubmed: 30760090
Mod Pathol. 2016 Apr;29(4):421-6
pubmed: 26847174
Kidney Int. 2020 Jan;97(1):163-174
pubmed: 31901340
J Am Soc Nephrol. 2017 Sep;28(9):2579-2589
pubmed: 28674044
Clin Chim Acta. 2013 Jun 5;421:213-8
pubmed: 23541686
J Am Soc Nephrol. 2017 Feb;28(2):421-430
pubmed: 27777266
N Engl J Med. 2014 Dec 11;371(24):2277-2287
pubmed: 25394321
Am J Kidney Dis. 2016 Jul;68(1):138-47
pubmed: 27085376
N Engl J Med. 2009 Jul 2;361(1):11-21
pubmed: 19571279
Nephrology (Carlton). 2015 Aug;20(8):572-5
pubmed: 26194981
Nephrol Dial Transplant. 2016 Sep;31(9):1486-93
pubmed: 26673907
J Autoimmun. 2020 Jan;106:102308
pubmed: 31395435
Indian J Nephrol. 2017 Sep-Oct;27(5):353-358
pubmed: 28904430
Sci Rep. 2015 Mar 05;5:8803
pubmed: 25740009
Indian J Nephrol. 2016 Jul-Aug;26(4):257-61
pubmed: 27512297
Kidney Int Rep. 2017 Sep 14;3(1):142-147
pubmed: 29340324
Nephron Extra. 2017 Feb 9;7(1):1-9
pubmed: 28413416
PLoS One. 2015 Sep 22;10(9):e0138841
pubmed: 26393352
Pediatr Nephrol. 2013 Dec;28(12):2307-11
pubmed: 23903693
Mod Pathol. 2018 Apr;31(4):616-622
pubmed: 29243738