期刊
JOURNAL OF NEPHROLOGY
卷 31, 期 6, 页码 899-905出版社
SPRINGER HEIDELBERG
DOI: 10.1007/s40620-018-0533-z
关键词
Anti-phospholipase A2 receptor (PLA2R) antibody; Membranous nephropathy; Enzyme-linked immunosorbent assay (ELISA); Receiver operating characteristic (ROC); Cut-off value
Autoantibodies against phospholipase A2 receptor (PLA2R) are a sensitive and specific marker for idiopathic membranous nephropathy (IMN). The aim of our study was to redefine the cut-off value for the measurement of anti-PLA2R autoantibody levels by an automated enzyme immunoassay, in a large single-center cohort of Italian IMN patients at the time of diagnosis. Sixty-seven consecutive incident patients, with biopsy-proven IMN, were recruited. All patients were naive to preceding immunosuppressive therapeutic regimens. The patient population had a mean age of 57years and included 48 males and 19 females. Also, 200 patients with other renal diseases and 36 healthy subjects were studied as controls. The anti-PLA2R autoantibody levels were measured using the commercial enzyme-linked immunosorbent assay kit at the time of renal biopsy. At a cut-off value of 2.7RU/ml (significantly lower than the manufacturer's recommended value of 14RU/ml), calculated by receiver operating characteristic curves, the sensitivity and specificity of anti-PLA2R autoantibodies in the diagnosis of IMN was 88.1 and 96% respectively. The adapted cut-off value of 2.7UI/ml increased sensitivity without affecting the specificity and it should be the recommended value for this method. Additionally our study confirmed the correlation, at baseline, between anti-PLA2R autoantibody levels and other biomarkers of disease activity.
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