Prevalence of renal biopsy deposits of antibodies against M-type phospholipase A2 receptor (PLA2R) in patients with diagnosis of primary and secondary membranous nephropathy

Abstract

Clinical Research with a proposal to study 70 patients with primary and secondary Membranous Nephropathy diagnosed by renal biopsy. Frequent pathology, in our environment, may present spontaneous remission or progress to chronic renal failure. Initially considered an immune disease by circulating immunocomplexes equivalent of chronic serum sickness, more recent studies have demonstrated that this is an autoimmune response to the own antigens expressed in the cell membrane of the podocytes. The Salant et al. group15 identified in 70% of patients with primary membranous nephropathy autoantibodies to the phospholipase A2 receptor, a 185-kD protein present in normal podocytes. The discovery is an important finding and may provide new tools for diagnosis and treatment, and disease activity monitoring. The antibody positivity in the biopsy is indicative of primary disease, which reduces the cost and time of clinical and laboratory investigation of secondary causes. On the other hand, the studies have been shown the relationship between circulating autoantibody anti-phospholipase A2 receptor and disease activity and clinical outcome, with potential prognostic and therapeutic implications. Methods: 70 cases of membranous nephropathy and 30 cases of lupus nephritis (secondary membranous form-WHO Class V) of the Discipline of Nephrology of Botucatu Medical School (UNESP) were selected. Anti-PLA2R antibody screening will be performed on biopsies and serum by immunofluorescence and Elisa techniques. Serum screening will be performed in follow-up patients and in new cases. The presence or absence of the antibody will be correlated with the clinical data and outcome. (AU)