Effects of phospholipase $ A_{2} $ receptor and thrombospondin type-1 domain-containing 7A expression in glomerular basement membranes on treatment response and renal outcome in membranous nephropathy

Background The aim of this study was to define the clinicopathologic features of phospholipase $ A_{2} $ receptor ($ PLA_{2} $R) and/or thrombospondin type-1 domain-containing 7A (THSD7A) associated membranous nephropathy(MN) focusing on their impact to disease relapse and response to treatment. Methods A total of 201 patients were enrolled for baseline clinical and histopathological features and 102 patients with a clinical follow-up for more than 1 year were evaluated for outcomes. Immunohistochemical staining was performed with $ PLA_{2} $R and THSD7A antibodies on kidney biopsies and glomerular staining was evaluated. Results $ PLA_{2} $R expression was observed in 75% of the patients’ biopsies; however, THSD7A expression was present only in 7 patients’ biopsies (3.5%). No significant difference was found between histopathological and clinical features of $ PLA_{2} $R positive and negative patients, collectively. Glomerular $ PLA_{2} $R expression was significantly associated with complete and complete/partial remission with first-line treatment; however, overall complete, and complete/partial remission rates did not differ from $ PLA_{2} $R negative patients (p = 0.2 and p = 0.8). Male gender, the presence of IgG4 staining and a necessity of immunosuppressive treatment were significantly associated with glomerular $ PLA_{2} $R expression. One patient, who developed end-stage renal disease, had glomerular expression for both $ PLA_{2} $R and THSD7A. Three patients with THSD7A-positive MN achieved complete remission. Conclusions The probability of achieving complete remission is high in patients with $ PLA_{2} $R-positive MN for whom the relapse rate was also higher. The overall renal outcome did not differ from $ PLA_{2} $R negative cases. Low incidence of THSD7A-positive MN reduces the possibility of future randomized controlled trials..

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:25

Enthalten in:

Clinical and experimental nephrology - 25(2021), 5 vom: 18. Jan., Seite 488-500

Sprache:

Englisch

Beteiligte Personen:

Yeter, Hasan H. [VerfasserIn]
Isik Gonul, Ipek [VerfasserIn]
Eraslan, Esra [VerfasserIn]
Karacalik, Ceren [VerfasserIn]
Ogut, Betul [VerfasserIn]
Guz, Galip [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.88$jUrologie$jNephrologie

Themen:

Membranous nephropathy
Outcome
Phospholipase A
Receptor
Relapse
Thrombospondin type-1 domain-containing 7A

Anmerkungen:

© Japanese Society of Nephrology 2021

doi:

10.1007/s10157-020-02011-6

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC212485531X

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