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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
DOI: 10.1097/TP.0000000000000630
ISSN: 0041-1337,1534-6080
Leer publicación
QUINTANA, LUIS F.
BLASCO, MIQUEL
SERAS, MIGUEL
PÉREZ, NURIA S.
MARCOS LOPEZ HOYOS
VILLARROEL, PATRICIA
EMILIO RODRIGO CALABIA
VIÑAS, ODETTE
ERCILLA, GUADALUPE
DIEKMANN, FRITZ
JOSE JAVIER GOMEZ ROMAN
GEMA FERNANDEZ FRESNEDO
OPPENHEIMER, FEDERICO
MANUEL ANTONIO ARIAS RODRIGUEZ
CAMPISTOL, JOSEP M.
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