Buscar

Estamos realizando la búsqueda. Por favor, espere...

 Detalle_Publicacion

Antiphospholipase A2 Receptor Antibody Levels Predict the Risk of Posttransplantation Recurrence of Membranous Nephropathy

Abstract: Background. Secretory phospholipase A2 receptor (PLA2R) is the target antigen of the auto-antibodies produced in most (~70%) patients with primary membranous nephropathy (pMN). The applicability of anti-PLA2R1 antibody monitoring for the prediction ofMN recurrence in kidney transplant recipients still is amatter of debate.Methods.We sought to characterize the presence and concentration of anti-PLA2R antibodies by enzyme-linked immunosorbent assay (ELISA) in a cohort of 21 patients with pMN before and after transplantation to evaluate whether anti-PLA2R concentrations could predict pMN recurrence. Results. The presence of pMN recurrence was significantly correlated with the existence of a positive ELISA assay at graft biopsy or with high level of anti-PLA2R1 activity before transplantation (P = 0.03). In the receiver operating characteristic analysis, anti-PLA2R levels (cut-off of 45 U/mL) during the pretransplantation period accurately predicted pMN recurrence, with a sensitivity of 85.3%, specificity of 85.1%, negative predictive value of 92%, and an area under the curve of 90.8%. This finding supports the hypothesis that anti-PLA2R cause pMN recurrence in humans and indicates the need to prove in an experimental model. Furthermore, 6 of 7 patients with recurrence were carriers of HLA DQA1* 05:01/05 and DQB1* 02:01, confirming these DQ alleles as those associated with higher anti-PLA2R levels. Conclusions. This study is the first to demonstrate pretransplantation circulating anti-PLA2R antibodies in a cohort of renal transplant recipients who prospectively developed recurrent disease. Currently, anti- PLA2R levels measured by ELISA may be a rational tool to establish the risk of MN recurrence in renal allograft recipients.

 Fuente: Transplantation. 2015 Aug;99(8):1709-14

Editorial: Lippincott Williams & Wilkins

 Fecha de publicación: 01/08/2015

Nº de páginas: 6

Tipo de publicación: Artículo de Revista

 DOI: 10.1097/TP.0000000000000630

ISSN: 0041-1337,1534-6080

Autores/as

QUINTANA, LUIS F.

BLASCO, MIQUEL

SERAS, MIGUEL

PÉREZ, NURIA S.

VILLARROEL, PATRICIA

VIÑAS, ODETTE

ERCILLA, GUADALUPE

DIEKMANN, FRITZ

OPPENHEIMER, FEDERICO

MANUEL ANTONIO ARIAS RODRIGUEZ

CAMPISTOL, JOSEP M.