Western Blotting of Glomerular Proteins with Serum from
Western Blotting of Glomerular Proteins with Serum from Patients with IMN. Beck Jr LH, et al. N Engl J Med 2009; 361: 11
Glassock RJ. N Engl J Med, 2009, 361: 81
Detection of anti-PLA 2 R in idiopathic MN
Recognition of idiopathic MN serum with deglycosylated PLA 2 R
Table Anti-PLA 2 R in Chinese patients with membranous nephropathy The prevalence of anti-PLA 2 R in idiopathic MN and secondary MN n Anti-PLA 2 R % Idiopathic MN 60 49 81. 7% Lupus MN 20 1 5. 0% HBV-MN 16 1 6. 3% Tumor-MN 10 3 30%
Why remain 11 IMN patients negative? There was an absence of immunologic disease activity at the time when their serum was sampled, despite proteinuria.
Low titer of anti-PLA 2 R in negative idiopathic MN Low titer of anti-PLA 2 R existed in 10 of remaining 11 negative IMN. PC: a MN serum that was positive under standard conditions diluted to 1: 1000. HC, Healthy control, serum from healthy adult (1: 10).
Association of anti-PLA 2 R with disease activity
Anti-PLA 2 R in IMN and IMN with complete remission 81. 7% 19. 0%
Ig. G 4 deposition in glomeruli of tumor-MN. A. Ig. G 4 in a glomerulus of a patient with tumor-MN but without circulating anti-PLA 2 R antibodies. B. Bright Ig. G 4 in a glomerulus of a patient with tumor. MN and circulating anti-PLA 2 R antibodies.
Follow-up of tumor-MN Ø All three patients with Anti-PLA 2 R : persistent or relapse of proteinuria despite resection of the tumor. Ø In those patients without anti-PLA 2 R: • 2 patients: complete remission of the proteinuria after tumor resection; • 3 patients died of cancer; • The remaining 2 patients had persistent proteinuria without tumor resection.
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