scholarly journals Diagnostic Utility of Serum and Urine Biomarkers in Idiopathic Membranous Nephropathy: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Dan Gao ◽  
Li-Ping Lu ◽  
Zhi-Guo Zhao
Keyword(s):  
Clinical Diagnosis ◽  
Membranous Nephropathy ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Idiopathic Membranous Nephropathy ◽  
Circular Rnas ◽  
Type I ◽  
Diagnostic Efficiency ◽  
Phospholipase A2 Receptor ◽  
The Future

Abstract Background Membranous nephropathy is an autoimmune nephropathy that is one of the most common pathological types of nephrotic syndrome. It is important to find and apply specific biomarkers for the noninvasive diagnosis of idiopathic membranous nephropathy (IMN). However, there are limited data about their diagnostic value. Therefore, an overall meta-analysis helps to identify effective biomarkers for the clinical diagnosis of IMN. Methods A systematic literature search was carried out in PubMed, Embase, Cochrane and Web of Science from inception until December 31, 2020. Two researchers searched for studies that met the inclusion criteria. The results of the joint study were expressed in terms of sensitivity and specificity. Results The meta-analysis included 24 studies with biomarkers for the clinical diagnosis of IMN, including phospholipase A2 receptor (PLA2R), thrombospondin type I domain-containing 7A (THSD7A), lysosome membrane protein-2 (LIMP-2) and circular RNAs. The diagnostic efficiency of PLA2R for IMN had a combined sensitivity of 60% and a combined specificity of 100%. The diagnostic efficiency of THSD7A for IMN had a combined sensitivity of 3% and a combined specificity of 99%. The diagnostic efficiency of urinary LIMP-2 for IMN was 100%, and the specificity was 100%. The diagnostic efficiency of exosomal circRNAs for IMN was 100%, and the specificity was 100%. Conclusions This meta-analysis shows that PLA2R and THSD7A are of important diagnostic value for IMN. More studies are needed in the future to reveal the diagnostic value of LIMP-2 and circRNAs for IMN. At the same time, other new diagnostic biomarkers in IMN need to be found in the future.

scholarly journals Meta‐Analysis of the Diagnostic Efficiency of THSD7A‐AB for the Diagnosis of Idiopathic Membranous Nephropathy

2020 ◽  
Vol 4 (11) ◽  
pp. 1900099
Author(s):  
Yipeng Liu ◽  
Shanshan Zheng ◽  
Chaoqun Ma ◽  
Ying Lian ◽  
Xiaoli Zheng ◽  
...  
Keyword(s):  
Membranous Nephropathy ◽  
Meta Analysis ◽  
Idiopathic Membranous Nephropathy ◽  
Diagnostic Efficiency

scholarly journals Diagnostic accuracy of anti-phospholipase A2 receptor (PLA2R) antibodies in idiopathic membranous nephropathy: an Italian experience

2020 ◽  
Author(s):  
Brunetta Porcelli ◽  
Andrea Guarnieri ◽  
Fabio Ferretti ◽  
Guido Garosi ◽  
Lucia Terzuoli ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Clinical Diagnosis ◽  
Membranous Nephropathy ◽  
Immunosuppressive Treatment ◽  
Positive Likelihood Ratio ◽  
Idiopathic Membranous Nephropathy ◽  
Renal Diseases ◽  
Enzyme Linked Immunosorbent Assay ◽  
Special Focus ◽  
Phospholipase A2 Receptor

Abstract Background Autoantibodies against-phospholipase A2 receptor (PLA2R) are specific markers of idiopathic membranous nephropathy (iMN). Enzyme-linked immunosorbent assay (ELISA) is becoming the preferred method in many laboratories for the determination of anti-PLA2R antibodies, because it provides quantitative results, and is not prone to subjective interpretation, as is the case with indirect immunofluorescence assay. Methods The purpose of our study was to determine the diagnostic performance of serum PLA2R antibodies detected by commercially available ELISA in a large Italian multicenter cohort of patients with biopsy-proven iMN and in patients with other renal diseases, with special focus on evaluating the optimal cut-off value to discriminate positive and negative results. A total of 495 consecutive patients were recruited. Renal biopsies were performed in all patients, and blood samples were taken before the initiation of immunosuppressive treatment. Results According to the clinical diagnosis and to kidney biopsy, 126 patients were diagnosed with iMN and 369 had other non-membranous nephropathies. Anti-PLA2R autoantibodies were detected using a commercial anti-PLA2R ELISA. At a cut-off value of 20 relative units (RU)/ml indicated by the manufacturer for positive classification, sensitivity was 61.1% and specificity 99.7%. At a cut-off value of 14 RU/ml indicated by the manufacturer for borderline results, sensitivity was 63.5% and specificity remained the same (99.7%). At a cut-off of 2.7 RU/ml, selected as the optimal cut-off on the basis of ROC curve analysis, sensitivity was 83.3% and specificity 95.1%. The best overall efficiency of the test was observed at 2.7 RU/ml; however, the highest positive likelihood ratio and diagnostic odds ratio were achieved at 14 RU/ml. A cut-off threshold higher than 14 RU/ml or lower than 2.7 RU/ml entailed worse test performance. Conclusion Depending on the clinical use (early diagnosis or as a support to confirm clinical diagnosis), nephrologists may take advantage of this evidence by choosing the most convenient cut-off. However, renal biopsy remains mandatory for the definitive diagnosis of iMN and for the assessment of disease severity.

scholarly journals Serum anti-phospholipase A2 receptor (PLA2R) antibody detected at diagnosis as a predictor for clinical remission in patients with primary membranous nephropathy: a meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yufeng Liang ◽  
Jianxin Wan ◽  
Yongping Chen ◽  
Yangbin Pan
Keyword(s):  
Phospholipase A2 ◽  
Subgroup Analysis ◽  
Membranous Nephropathy ◽  
Clinical Remission ◽  
Remission Rate ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Diagnostic Value ◽  
Clinical Remission Rate ◽  
Phospholipase A2 Receptor

Abstract Background The diagnostic value of serum M-type phospholipase A2 receptor antibody (sPLA2R-ab) expression in patients with primary membranous nephropathy (PMN) has been established. However, the association between sPLA2R-ab and clinical remission remains uncertain. Methods We systematically searched the literature for clinical trials regarding the correlation between sPLA2R-ab expression and clinical remission of PMN patients. Meta-analysis was performed to determine this association. Subgroup analysis, funnel plots, and sensitivity analysis were also performed to investigate heterogeneity or bias. Results A total of 11 trials involving 824 patients were included. Patients with positive sPLA2R-ab had a poor clinical remission rate (RR = 0.76, 95%CI 0.68–0.86, P < 0.0001; I2 = 39%), a higher titer of sPLA2R-ab had a lower chance of clinical remission (RR = 0.72, 95%CI 0.59–0.87, P = 0.0006; I2 = 42%),and a higher risk of renal failure (RR = 4.85, 95% CI, 1.83–12.85, P = 0.002; I2 = 0%), without affecting relapse (RR = 0.97, 95% CI, 0.55–1.70; P = 0.92, I2 = 0%). Subgroup analysis by treatment strategies, assay methods, ethnicity, gender, renal function, the approach of ruling out SMN, and the ratio of patients with nephrotic-range proteinuria at baseline showed no significant association between these factors with the prognostic value of sPLA2R-ab for PMN patients. No significant publication bias was found. Conclusion This meta-analysis adds to the evidence for current guidelines that sPLA2R-ab acts as not only a diagnostic marker but also a pivotal predictor for clinical remission. Therefore, sPLA2R-ab can be considered as a prognostic factor for stratifying PMN patients.

A novel time-resolved fluoroimmunoassay based on magnetic microspheres method for detecting antibodies against Phospholipase A2 Receptor

2021 ◽  
Author(s):  
ting li ◽  
qingqing wu ◽  
Xue Yang ◽  
Yueming liu ◽  
bo lin ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Disease Activity ◽  
Membranous Nephropathy ◽  
Magnetic Microspheres ◽  
Idiopathic Membranous Nephropathy ◽  
Serum Antibodies ◽  
Time Resolved ◽  
Phospholipase A2 Receptor

Background: The level of serum antibodies against the M-type phospholipase A2 receptor (anti-PLA2R-IgG) is closely related to the disease activity of idiopathic membranous nephropathy (IMN). Therefore, the establishment of a...

scholarly journals Phospholipase A2 Receptor (PLA2R1) Sequence Variants in Idiopathic Membranous Nephropathy

2013 ◽  
Vol 24 (4) ◽  
pp. 677-683 ◽  
Author(s):  
Marieke J.H. Coenen ◽  
Julia M. Hofstra ◽  
Hanna Debiec ◽  
Horia C. Stanescu ◽  
Alan J. Medlar ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Membranous Nephropathy ◽  
Idiopathic Membranous Nephropathy ◽  
Sequence Variants ◽  
Phospholipase A2 Receptor
Sign in / Sign up

Export Citation Format

Share Document