MO299RELATIONSHIP BETWEEN LOW-TITER PHOSPHOLIPASE A2 RECEPTOR ANTIBODY AND TREATMENT RESPONSE OF IDIOPATHIC MEMBRANOUS NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Haoyuan Cui ◽  
Chao Li ◽  
Hang Li ◽  
Yu-bing Wen ◽  
Limeng Chen ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Treatment Response ◽  
High Titer ◽  
Baseline Data ◽  
Chinese Patients ◽  
Female Ratio ◽  
Phospholipase A2 Receptor ◽  
Titer Group ◽  
One Year

Abstract Background and Aims The circulating anti-Phospholipase A2 receptor (PLA2R) antibody has been widely detected since its discovery in 2009. It was suggested that the cut-off of serum PLA2R antibody (PLA2RsAb) should be reset at below 20 RU/mL to prove diagnostic efficacy. The correlation between low titer PLA2RsAb and treatment response has not been discussed. In this study, we focused on the low titer PLA2RsAb during follow-up of PLA2R-related IMN. Method We retrospectively enrolled 43 Chinese patients with biopsy-proved PLA2R-related IMN from March 2017 to October 2019. Baseline data were collected including age, gender, serum creatinine (Scr), albumin (Alb), 24h urine protein (24hUP), and PLA2RsAb at biopsy. PLA2RsAb was detected at one month, three months, six months and one year. The patients were stratified into three groups by the lowest PLA2RsAb titer during follow up. Low titer group was defined as anti-PLA2R antibody ＜2RU/mL (53.5%, n=23). Median titer group was defined as anti-PLA2R antibody >2 but ＜20RU/mL (32.6%, n=14). High titer group was defined as anti-PLA2R antibody >20RU/mL (13.9%, n=6). Complete remission (CR) was defined as 24hUP ＜0.3g/d. Partial remission (PR) was defined as 24hUP at the range of 0.3-3.5g/d and a reduction >50% of the baseline proteinuria. No remission (NR) was defined as absence of CR or PR at one-year. Results In the entire cohort, patients were 49 ± 16 years old with 28/15 male/female ratio. Baseline data of low, mid and high titer group were as follows: the median PLA2RsAb were 34.3(22.1, 314), 103(55.8, 361), 73.6(53.0, 215)RU/mL, P = 0.305; the median 24hUP were 6.8(3.5, 12.4), 6.4(5.6, 8.9), 4.9(3.4, 7.2)g/d, P = 0.493; the average Scr were 100.4 ± 60.0, 92.3 ± 29.2, 82.0 ± 21.9 umol/L, P = 0.681; the median Alb were 27.0 ± 5.7, 23.8 ± 5.8, 30.2 ± 3.3 g/L, P = 0.054. The rate of CR, PR, NR were 34.8% (8/23), 34.8% (8/23), 30.4% (7/23) in low titer group, 7.1% (1/14), 71.4% (10/14), 21.4% (3/14) in mid titer group, 0% (0/6), 66.7% (4/6), 33.3% (2/6) in high titer group, P = 0.119 Conclusion The correlation between low titer PLA2RsAb and treatment response showed no statistical significance.

Comparing polymer-filled versus self-expanding endografts in Chinese patients

2018 ◽  
Vol 26 (9) ◽  
pp. 667-676
Author(s):  
Yuk Law ◽  
Yiu Che Chan ◽  
Stephen Wing-Keung Cheng
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
The Self ◽  
Chinese Patients ◽  
Type Ii ◽  
Mortality And Morbidity ◽  
Type Ia ◽  
One Year ◽  
Aneurysm Repair

Introduction We performed a single-center nonrandomized study on patients who underwent endovascular aneurysm repair using polymer-filled or other self-expanding endografts. Methods Consecutive patients with asymptomatic infrarenal abdominal aortic aneurysms who underwent endovascular repair were retrospectively reviewed. They were divided into a polymer-filled ( n = 20) or self-expanding group ( n = 42). Baseline characteristics, operative mortality and morbidity, and follow-up data were compared. Results Aneurysm diameter, neck and iliac morphologies did not differ between the two groups. Technical success was 100%. The 30-day mortality was 0% and 2.4% in the polymer-filled and self-expanding group, respectively. At a mean follow-up of 17 months, the changes in sac size were −2.1 mm and −5.1 mm ( p = 0.144) at one year, and −3.5 mm and −7.7 mm ( p = 0.287) at 2 years in the polymer-filled and self-expanding group, respectively. The polymer-filled group had 7 (35%) type II endoleaks, and the self-expanding group had 1 (2.4%) type Ia and 13 (31%) type II endoleaks. Neck diameter remained stable in the polymer-filled stent-grafts whereas there was progressive neck degeneration in the self-expanding group. The rates of reintervention and overall survival were similar in both groups. The presence of an endoleak was the only predictor of non-regression of the aneurysm (odds ratio = 17.00, 95% confidence interval: 4.46–64.88, p < 0.001). Conclusion Polymer-filled endografts had similar safety, effectiveness, and durability to other self-expanding endografts. The major advantage is the small iliofemoral access. They also have the potential long-term benefit of a more stable neck.

Primary non-Hodgkin's lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients.

1998 ◽  
Vol 16 (1) ◽  
pp. 70-77 ◽  
Author(s):  
M M Cheung ◽  
J K Chan ◽  
W H Lau ◽  
W Foo ◽  
P T Chan ◽  
...  
Keyword(s):  
Clinical Features ◽  
Survival Rates ◽  
Chinese Patients ◽  
Female Ratio ◽  
Cd56 Expression ◽  
T Lymphomas ◽  
Hodgkin's Lymphomas ◽  
Male To Female ◽  
Disease Free

PURPOSE To study the clinical features and outcome for primary non-Hodgkin's lymphomas of the nose/nasopharynx (NNP-NHLs) according to immunophenotype. PATIENTS AND METHODS One hundred thirteen Chinese patients with primary NNP-NHLs that belonged to the categories E, F, G, or H according to the Working Formulation (WF), with full immunophenotypic data and complete clinical follow-up data, were analyzed in this retrospective study. RESULTS Ninety (79.6%) patients had localized (stage I or II) disease, while 23 (20.4%) had stage III or IV disease. The lymphomas in 51 (45.1%), 24 (21.3%), and 38 (33.6%) patients showed natural killer (NK)/T- (CD56-positive), T-cell, and B-cell immunophenotype, respectively. Seventy-three patients (65.8%) achieved a complete remission, of whom 34 (46.6%) subsequently relapsed. The median follow-up time for those alive was 88 months. The 5-year actuarial disease-free and overall survival rates were 34.4% and 37.9%, respectively. Multivariate analysis showed that only stage and immunophenotype were significant for survival. NK/T lymphomas were distinctive among the three immunophenotypes in the following aspects: the highest male-to-female ratio, more frequent involvement of the nasal cavity alone, higher risk of dissemination to the skin, more frequent development of hemophagocytic syndrome, and the worst prognosis (overall median survival, 12.5 months). CONCLUSION The three immunophenotypes studied are shown to exhibit different clinical patterns. Since the NK/T phenotype carries the worst prognosis, patients who present with NNP-NHL should have their tumors analyzed for CD56 expression.

scholarly journals Camouflage effects following resin infiltration of postorthodontic white-spot lesions in vivo: One-year follow-up

2015 ◽  
Vol 85 (3) ◽  
pp. 374-380 ◽  
Author(s):  
Amely Eckstein ◽  
Hans-Joachim Helms ◽  
Michael Knösel
Keyword(s):  
White Spot ◽  
White Spot Lesions ◽  
Female Ratio ◽  
Significance Level ◽  
Resin Infiltration ◽  
Male Female Ratio ◽  
The Difference ◽  
One Year

ABSTRACT Objective:  To assess camouflage effects by concealment of postorthodontic white-spot lesions (WSLs) to sound adjacent enamel (SAE) achieved over 12 months with resin infiltration (Icon, DMG, Hamburg, Germany). Methods:   Twenty subjects (trial teeth nteeth = 111) who had received resin infiltration treatment of noncavitated postorthodontic WSLs were contacted for a 1-year follow-up assessment of CIE-L*a*b* colors (T12). Color and lightness (CIE-L*a*b*) data for WSLs and SAE were compared to baseline data assessed before infiltration (T0) and those assessed after 6 months (T6), using a spectrophotometer. The target parameter was the difference between the summarized color and lightness values (ΔEWSL/SAE). Intergroup (WSL, SAE) and intertime comparisons (T0 vs T6, T12) were performed using paired t-tests at a significance level of α = 5%. Results:  Nine subjects (trial teeth nteeth = 49; male/female ratio 5/4; age range 13–19 years) were available at T12. After the highly significant reduction of ΔEWSL/SAE discrepancies between T0 and T6, analysis of 12-month records revealed color and lightness discrepancy of WSL vs SAE that was significantly decreased compared with baseline, indicating an assimilation of WSL color to SAE appearance after infiltration, while an additional reduction of discrepancies between T6 and T12 was not significant. Conclusion:  As color and lightness characteristics of the Icon infiltrant as well as the esthetic camouflage effects achieved by WSL infiltration were not altered significantly or clinically relevant after 12 months, the method of resin infiltration can be recommended for an enduring esthetic improvement of postorthodontic WSL. (Angle Orthod. 2015;85:374–380.)

Anti-Phospholipase A2 Receptor Antibody as Prognostic Indicator in Idiopathic Membranous Nephropathy

2015 ◽  
Vol 42 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Yang Gyun Kim ◽  
Young-Wook Choi ◽  
Se-Yun Kim ◽  
Ju Young Moon ◽  
Chun-Gyoo Ihm ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Membranous Nephropathy ◽  
Remission Rate ◽  
High Titer ◽  
Severe Disease ◽  
Idiopathic Membranous Nephropathy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Receptor Antibody ◽  
Phospholipase A2 Receptor

Background: Anti-phospholipase A2 receptor antibody (PLA2R-Ab) is useful in diagnosing idiopathic membranous nephropathy (IMN). We investigated the clinical relevance of PLA2R-Ab enzyme-linked immunosorbent assay (ELISA) in patients with IMN. Methods: We measured PLA2R-Ab with an ELISA kit from the serum of 160 patients with IMN (n = 93), secondary MN (n = 14) and other glomerulonephritis (n = 41) as well as healthy controls (n = 12) at the time of renal biopsy and investigated the correlation of titers of PLA2R-Ab with clinical parameters. Results: PLA2R-Ab was positive in 41 of 93 patients (44.1%) with IMN. No samples from the patients with secondary MN and other glomerulonephritis or healthy controls were positive with the ELISA test. The PLA2R-Ab-positive patients showed severe disease activity and a low remission rate. The PLA2R-Ab titer positively correlated with proteinuria and was negatively associated with renal function and serum albumin. The patients with a high titer of PLA2R-Ab had significantly decreased remission rates. The cumulative probabilities of remission was significantly lower in patients with PLA2R-Ab (p = 0.01) and even so in patients with a high titer of PLA2R-Ab (p = 0.04). When we compared the ELISA titers with Western blot (WB) data of 43 patients who had been enrolled in our previous study, 18 and 30 patients were positive on ELISA (41.9%) and WB (69.8%), respectively. WB and ELISA had a concordance rate of 72.1% and were positively correlated (r = 0.590, p < 0.001). Conclusion: The presence, as well as a high titer, of PLA2R-Ab on ELISA was associated with poor prognosis of IMN. Assessment of PLA2R-Ab with ELISA is an easy and reliable tool for the diagnosis and guidance of therapeutic plans.

scholarly journals Effect of belimumab on proteinuria and anti-phospholipase A2 receptor autoantibody in primary membranous nephropathy

2019 ◽  
Vol 35 (4) ◽  
pp. 599-606 ◽  
Author(s):  
Christine Barrett ◽  
Lisa C Willcocks ◽  
Rachel B Jones ◽  
Ruth M Tarzi ◽  
Robert B Henderson ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Membranous Nephropathy ◽  
Remission Induction ◽  
Experimental Medicine ◽  
Open Label ◽  
Intention To Treat ◽  
Phospholipase A2 Receptor ◽  
B Cell Subsets ◽  
Treat Population

Abstract Background Immunosuppressant drugs reduce proteinuria and anti-phospholipase A2 receptor autoantibodies (PLA2R-Ab) in primary membranous nephropathy (PMN) with varying success and associated toxicities. This study aimed to evaluate the effect of belimumab on proteinuria and PLA2R-Ab in participants with PMN. Methods In this prospective, open-label, experimental medicine study, 14 participants with PMN and persistent nephrotic-range proteinuria received up to 2 years belimumab monotherapy (10 mg/kg, every 4 weeks). Changes in proteinuria (urinary protein:creatinine ratio), PLA2R-Ab, albumin, cholesterol, B-cell subsets and pharmacokinetics were analysed during treatment and up to 6 months after treatment. Results Eleven participants completed to the primary endpoint (Week 28) and nine participants completed the study. In the intention-to-treat population population, baseline proteinuria of 724 mg/mmol [95% confidence interval (CI) 579–906] decreased to 498 mg/mmol (95% CI 383–649) and 130 mg/mmol (95% CI 54–312) at Weeks 28 and 104, respectively, with changes statistically significant from Week 36 (n = 11, P = 0.047). PLA2R-Ab decreased from 174 RU/mL (95% CI 79–384) at baseline to 46 RU/mL (95% CI 16–132) and 4 RU/mL (95% CI 2–6) at Weeks 28 and 104, respectively, becoming statistically significant by Week 12 (n = 13, P = 0.02). Nine participants achieved partial (n = 8) or complete (n = 1) remission. Participants with abnormal albumin and/or cholesterol at baseline gained normal/near normal levels by the last follow-up. Adverse events were consistent with those expected in this population. Conclusions Belimumab treatment in participants with PMN can reduce PLA2R-Ab and subsequently proteinuria, important preludes to remission induction.

scholarly journals Prospective evaluation of clinical profile and treatment outcome of patients presenting with polyarthritis diagnosed as rheumatoid arthritis

2012 ◽  
Vol 10 (2) ◽  
pp. 22-28
Author(s):  
Arpana Neopane ◽  
Mona Sharma ◽  
Sumugdha Rayamajhi
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Response ◽  
Clinical Presentation ◽  
Prospective Longitudinal Study ◽  
Early Presentation ◽  
Common Presentation ◽  
Characteristic Features ◽  
One Year ◽  
Prospective Longitudinal

Introduction: Polyarthritis is a common presentation of patients attending medicine outpatient department. Among various causes Rheumatoid arthritis is the commonest and a well established case has distinct characteristic features. However the early presentation of this disease has not been clear thus leading to delay in treatment. The objectives of this study was to identify the various causes of polyarthritis in our clinical practice, discuss the varied clinical presentation of rheumatoid arthritis including early Rheumatoid arthritis and to evaluate the treatment response during one year follow up. Methods: Prospective longitudinal study conducted in a teaching hospital over a two years period Results: Rheumatoid arthritis was the commonest cause of polyarthritis (77.8%) with a period prevalence of 0.7%. Early presentation included atypical features like asymmetry, unilateral presentation, manifesting within 2 months to 2 years of diagnosis. 43% (n=18) of the patients had swelling and tenderness in overused joints 1.5 years prior to full clinical manifestation. Flitting or migratory joint pain not considered to be a feature of rheumatoid arthritis was also present in 14.3% (n=6) patients with mean duration of 1.5 years prior to full blown presentation. MCPJ (metacarpophalyngeal joints) and PIP (proximal interphalyngeal joints) were involved in 90%. Treatment response with Methotrexate as a single DMARD was good as compared with DAS 28 ESR score. Conclusions: RA is a common arthritis with varied clinical presentation. Recognition of early symptoms is needed for early diagnosis and initiation of DMARD. Methotrexate as a DMARD is effective and should be initiated early. DOI: http://dx.doi.org/10.3126/mjsbh.v10i2.6459 Medical Journal of Shree Birendra Hospital July-Dec 2011 10(2) 22-28

scholarly journals Analysis of Glomerular IgG Subclasses Switch in Idiopathic Membranous Nephropathy Classified by Glomerular Phospholipase A2 Receptor Antigen and Serum Antibody

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hao-yuan Cui ◽  
Chao Li ◽  
Hang Li ◽  
Yu-bing Wen ◽  
Lin Duan ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Membranous Nephropathy ◽  
Serum Antibody ◽  
Chinese Patients ◽  
Idiopathic Membranous Nephropathy ◽  
Igg Subclass ◽  
Electron Microscopic ◽  
Phospholipase A2 Receptor ◽  
Stage 1

Background. The role of IgG subclass in idiopathic membranous nephropathy (IMN) was unclarified. Recent study found IgG subtype switches from IgG1 to IgG4 in the early pathological stage in IMN. The profile of IgG subclass in phospholipase A2 receptor- (PLA2R-) related and PLA2R-unrelated IMN was unrevealed. Our study is aimed at testifying whether IgG subclass switch existed in PLA2R-related and PLA2R-unrelated IMN, respectively. Methods. Our study retrospectively enrolled 157 Chinese patients with biopsy-confirmed IMN between September 2017 and November 2019. We measured glomerular PLA2R antigen and serum anti-PLA2R antibody to classify the patients into PLA2R-related ( n = 132 ) and PLA2R-unrelated ( n = 25 ) subgroup. We evaluated glomerular IgG subclass by immunofluorescence (IF) predominance. Our study defined IgG subclass deposition as predominant if the IF score was higher than the other three and ≥1 +, or as codominant if the IF intensity was equal to any other and ≥1 +. We explored the relationship between IF predominance of glomerular IgG subtype and electron microscopic (EM) stages of IMN. Results. We did not find statistical difference of predominant or codominant rate (pre/co-rate) among EM stages in any subclass ( P > 0.05 ). Pre/co-rate of IgG3 linearly associated with EM stage in total and PLA2R-related subgroup ( P = 0.044 , P = 0.013 ). PLA2R-related subgroup showed higher IgG4 intensity ( 2.1 ± 0.6 vs. 1.6 ± 0.7 , P = 0.001 ) and pre/co-rate of IgG4 in stage 1 (97% vs. 57%, P = 0.015 ) than PLA2R-unrelated group. We found no difference of IgG subclass pre/co-rate in different EM stages or linear association between pre/co-rate of IgG1, IgG2, IgG4, and EM stages ( P > 0.05 ). Conclusions. Pre/co-rate of IgG3 declined with EM stage in total and PLA2R-related subgroup. We did not find IgG subclass switches from IgG1 to IgG4 in either IMN patients or subgroups.

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