Coexistence of different circulating anti-podocyte antibodies in membranous nephropathy
| Autor: | Corrado Murtas, Pietro Ravani, Francesca Bruno, Maurizio Bruschi, Piergiorgio Messa, Riccardo Magistroni, Francesco Scolari, Giovanni Candiano, Landino Allegri, Andrea Magnano, Fernando C. Fervenza, Maria Luisa Carnevali, Gian Marco Ghiggeri, Lucia Argentiero, L. Furci, Renato Alberto Sinico, Antonella Radice, Gabriella Moroni, Loreto Gesualdo |
|---|---|
| Přispěvatelé: | Murtas, C, Bruschi, M, Candiano, G, Moroni, G, Magistroni, R, Magnano, A, Bruno, F, Radice, A, Furci, L, Argentiero, L, Carnevali, M, Messa, P, Scolari, F, Sinico, R, Gesualdo, L, Fervenza, F, Allegri, L, Ravani, P, Ghiggeri, G |
| Rok vydání: | 2012 |
| Předmět: |
Male
Registrie nefrologia Time Factors Epidemiology glomerulonefrite membranosa Critical Care and Intensive Care Medicine Glomerulonephritis Membranous Immunoglobulin G Retrospective Studie Medicine Registries antigene Proteinuria biology Podocytes Glomerulosclerosis Focal Segmental Middle Aged Glomerulonephritis Membranou Isotype Autoantibodie sindrome nefrosica Italy Nephrology Linear Model Female Neprilysin medicine.symptom Human Adult Adolescent Logistic Model Time Factor Podocyte Nephropathy Young Adult Antigen Membranous nephropathy Aldehyde Reductase Humans Autoantibodies Retrospective Studies Aged Transplantation business.industry Superoxide Dismutase Receptors Phospholipase A2 Autoantibody Glomerulonephritis IGA Original Articles medicine.disease Logistic Models Phosphopyruvate Hydratase Immunology Linear Models biology.protein business |
| Popis: | Summary Background and objectives The discovery of different podocyte autoantibodies in membranous nephropathy (MN) raises questions about their pathogenetic and clinical meaning. This study sought to define antibody isotypes and correlations; to compare levels in MN, other glomerulonephritides, and controls; and to determine their association with clinical outcomes. Design, setting, participants, & measurements Serum IgG1 ,I gG3 ,a nd IgG4 against aldose reductase (AR), SOD2, and a-enolase (aENO) were measured at diagnosis in 186 consecutive MN patients, in 96 proteinuric controls (36 with FSGS, and 60 with IgA nephropathy), and in 92 healthy people recruited in four Italian nephrology units. Anti-phospholipase A2 receptor (PLA2r) and anti-neutral endopeptidase (NEP) IgG4 were titrated in the same specimens. Association with 1-year follow-up clinical parameters was studied in 120 patients. Results IgG4 was the most common isotype for all antibodies; IgG1 and IgG3 were nearly negligible. IgG4 levels werepositiveinasignificantproportionofMNpatients(AR,34%;SOD2,28%;aENO,43%).Antibodytiterswere higher in MN than in healthy and pathologic controls (P,0.005). Anti-NEP IgG4 did not differ from normal controls (P=0.12). Anti-PLA2r IgG4 was detected in 60% of patients and correlated with anti-AR, anti-SOD2, and anti-aENO IgG4 (P,0.001). In MN patients negative for the whole antibody panel (20%), 1-year proteinuria was lower compared with patients with at least one antibody positivity (P,0.05). Conclusions Our data suggest that IgG4 is the prevalent isotype for antibodies against cytoplasmic antigens of podocytes (AR, SOD2, aENO). Their levels were higher than in other proteinuric glomerulonephritides and in normal controls and were correlated with anti-PLA2r. Only baseline negativity for all known antibodies predicted lower 1-year proteinuria. Clin J Am Soc Nephrol 7: ccc–ccc, 2012. doi: 10.2215/CJN.02170312 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|