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Idiopathic Membranous Nephropathy Antigen Found

Last Updated: July 01, 2009.

In patients with idiopathic membranous nephropathy, the M-type phospholipase A2 receptor is a major target antigen, a finding that may improve diagnosis and treatment, according to a study published in the July 2 issue of the New England Journal of Medicine.

WEDNESDAY, July 1 (HealthDay News) -- In patients with idiopathic membranous nephropathy, the M-type phospholipase A2 receptor (PLA2R) is a major target antigen, a finding that may improve diagnosis and treatment, according to a study published in the July 2 issue of the New England Journal of Medicine.

Laurence H. Beck Jr., M.D., of the Boston University School of Medicine, and colleagues performed Western blotting of extracts of normal human glomeruli from donor kidneys with serum samples from 37 patients with idiopathic membranous nephropathy, 15 patients with other proteinuric conditions, seven patients with other autoimmune disorders, eight patients with secondary membranous nephropathy, and 30 healthy controls.

The researchers detected a 185-kD protein band in 26 (70 percent) of patients with idiopathic membranous nephropathy, and mass spectrometry of the reactive protein band detected PLA2R. In serum samples from patients with idiopathic membranous nephropathy, they also found that anti-PLA2R autoantibodies were mainly IgG4. None of the serum samples from the other patients reacted with the antigen.

"It is likely that the seminal observations of Beck et al. will have a profound effect on how clinicians approach the diagnosis and treatment of membranous nephropathy," states the author of an accompanying editorial. "Assays for anti- PLA2R autoantibody (and perhaps anti-neutral endopeptidase as well) may permit the noninvasive diagnosis of membranous nephropathy as well as provide a convenient way to follow the activity of the disease in response to treatment."

The study was partially supported by Amgen; one author reported a financial relationship with Amgen.

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