Immune Response against Autoantigen PLA2R Is not Gambling: Implications for Pathophysiology, Prognosis, and Therapy

Dębiec, Hanna; Ronco, Pierre

doi:10.1681/asn.2015101170

Cited by 24 publications

(28 citation statements)

References 21 publications

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“…All patients with biopsy-proven MGN should be screened for anti-PLA 2 R/THSD7A, as well as hepatitis C, hepatitis B, lupus nephritis antigens, and malignancies to rule out secondary causes [86][87][88].…”

Section: Diagnosismentioning

confidence: 99%

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

et al. 2019

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The detection of phospholipase A2 receptor (PLA2R) and thrombospondin domain containing 7A THSD7A among primary membranous glomerulonephritis (MGN) patients transformed the diagnosis, treatment monitoring, and prognosis. Anti-PLA2R can be detected in 70–90% of primary MGN patients while anti-THSD7A in 2–3% of anti-PLA2R negative primary MGN patients depending on the technique used. Serum and urine samples are less invasive and non-invasive, respectively, and thus can detect the presence of anti-PLA2R and anti-THSD7A with higher sensitivity and specificity, which is significant in patient monitoring and prognosis. It is better than exposing patients to a frequent biopsy, which is an invasive procedure. Different techniques of detection of PLA2R and THSD7A in patients’ urine and sera were reviewed to provide newer and alternative techniques. We proposed the use of biomarkers (PLA2R and THSD7A) in the diagnosis, treatment decision, and follow-up of patients with primary MGN. In addition, other prognostic renal biomarkers like retinol binding protein (RBP) and beta-2 microglobulin were reviewed to detect the progression of renal damage for early intervention.

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Section: Diagnosismentioning

confidence: 99%

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

et al. 2019

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“…Primary membranous nephropathy (PMN), a common cause of the nephrotic syndrome in adults, is an organ-specific autoimmune disease (1)(2)(3)(4)(5)(6)(7)(8). Most PMN cases (about 85%) are mediated by antibodies to anti-phospholipase A2 receptor (anti-PLA2R), while the rest are related to thrombospondin type 1 domain containing 7A (anti-THSD7A) or unidentified mechanisms (4,7,9,10). The disease activity of PMN is closely associated with anti-PLA2R level and 24-h urine protein quantification (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Myeloid-Derived Suppressor Cells Promote the Progression of Primary Membranous Nephropathy by Enhancing Th17 Response

Guo

et al. 2020

Front. Immunol.

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Several studies have confirmed that the myeloid-derived suppressor cells (MDSCs) are closely associated with autoimmune diseases, but their exact role in these processes remains largely unclear. Here, we investigated the role MDSCs in patients with primary membranous nephropathy (PMN). Compared to healthy controls (HCs), PMN patients showed significantly increased number of HLA-DR − CD11b + CD33 + MDSCs in the peripheral blood, including both CD14 + CD66b − monocytic and CD14 − CD66b + granulocytic MDSCs. The frequency of MDSCs was positively correlated with the level of serum anti-phospholipase A2 receptor (anti-PLA2R), 24-h urine protein quantification, and disease activity in PMN patients. Consistently, enhanced T helper 2 (Th2) and T helper 17 (Th17) immune responses were positively associated with plasma anti-PLA2R levels, 24-h urine protein quantification, and the disease activity in PMN patients. Moreover, compared to HCs, MDSCs from PMN patients exhibited significantly elevated arginase-1 (ARG-1) production and increased potential to promote Th17 differentiation in vitro in an ARG-1-dependent manner. This study directly demonstrates a pathogenic role for MDSCs in human PMN and provides a molecular mechanism for the pathogenesis of PMN. Our data show that MDSCs may promote PMN disease progression mainly by enhancing Th17 response. Therefore, MDSCs may be an important diagnostic, therapeutic, and prognostic marker for PMN diseases.

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“…All patients with biopsy-proven MGN should be screened for anti-PLA2R/THSD7A as well as hepatitis C, hepatitis B, lupus nephritis antigens and malignancies to rule out secondary causes ( Francis JM, Beck LH Jr., 2011;Debiec H, 2016;De Vriese, et al, 2017).…”

Section: Diagnosismentioning

confidence: 99%

Membranous Glomerulonephritis: Overview of the Role of Serum and Urine Biomarkers in the Management

Maifata¹,

Hod²,

Zakaria³

et al. 2019

Preprint

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Detection of PLA2R and THSD7A among primary membranous glomerulonephritis (MGN) patients transformed the diagnosis, treatment monitoring and prognosis. Anti-PLA2R can be detected in 70-90% of primary MGN patients while anti-THSD7A in 2-3% of anti-PLA2R negative primary MGN patients depending on the technique used. Serum and urine samples are less invasive and non-invasive respectively and can detect the presence of anti-PLA2R and anti-THSD7A with higher sensitivity and specificity, significant in patients’ monitoring and prognosis better than exposing patients to frequent biopsy which is an invasive procedure. Different techniques of detection of PLA2R and THSD7A in patients’ urine and sera were reviewed with the aim of providing newer and alternative techniques. We proposed the use of biomarkers (PLA2R and THSD7A) in making the diagnosis, treatment decision and follow up of patients with primary MGN. We also reviewed other prognostic renal biomarkers like retinol binding protein (RBP) and beta-2 microglobulin in order to detect progression of renal damage for early intervention.

show abstract

Immune Response against Autoantigen PLA2R Is not Gambling: Implications for Pathophysiology, Prognosis, and Therapy

Cited by 24 publications

References 21 publications

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

Myeloid-Derived Suppressor Cells Promote the Progression of Primary Membranous Nephropathy by Enhancing Th17 Response

Membranous Glomerulonephritis: Overview of the Role of Serum and Urine Biomarkers in the Management

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