Abstract
Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults. Autoantibodies against M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A), which mainly belong to the IgG4 subclass, were reported as associated antibodies for the development of MN. Although PLA2R is a major target antigen for idiopathic MN, the prevalence of MN patients seropositive for PLA2R in Japan is lower than that in other countries. In this study, we conducted immunohistochemical analysis of the presence of THSD7A and PLA2R in renal specimens of MN patients to estimate the prevalence of THSD7A/PLA2R-related idiopathic MN in Japan. Enhanced granular expression of THSD7A and PLA2R was detected in 9.1% and 52.7%, respectively, of the patients with idiopathic MN. Although none of patients with secondary MN displayed enhanced granular expression of THSD7A, 5.4% of them had enhanced granular expression of PLA2R. In conclusion, the prevalence of enhanced granular expression of THSD7A in the glomeruli of Japanese patients with idiopathic MN was higher than the prevalence of MN patients seropositive for THSD7A in USA and Europe.
Highlights
Membranous nephropathy (MN), which has idiopathic and secondary forms, is the main cause of nephrotic syndrome in adults [1]
We examined the prevalence of enhanced granular expression of THSD7A and phospholipase A2 receptor (PLA2R) in the glomeruli of Japanese patients with idiopathic MN by immunohistochemistry
Our results suggest that the prevalence of THSD7A-related MN in Japanese patients with idiopathic MN is higher than that in Europe and USA [16], whereas that of PLA2R-related MN is similar to the previously reported values [11]
Summary
Membranous nephropathy (MN), which has idiopathic and secondary forms, is the main cause of nephrotic syndrome in adults [1]. Hepatitis B and C viruses, autoimmune diseases, thyroiditis, malignancies, and the use of certain drugs have been reported to cause secondary MN [2]. MN had autoantibodies to PLA2R in their serum [3] After this discovery, there have been many reports on the prevalence of detection of anti-PLA2R antibodies in the serum of patients with idiopathic MN in many countries and regions, and this prevalence has been found to be in the range of 52% to 98% [4,5,6,7,8,9,10,11,12]
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