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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
QUINTANA, LUIS F.
PÉREZ, NURIA S.
MARCOS LOPEZ HOYOS
EMILIO RODRIGO CALABIA
JOSE JAVIER GOMEZ ROMAN
GEMA FERNANDEZ FRESNEDO
MANUEL ANTONIO ARIAS RODRIGUEZ
CAMPISTOL, JOSEP M.