PLA2R抗体在特发性膜性肾病中的价值

李 婷婷, 夏宇 龙*
晋中市中医院肾内科

摘要


特发性膜性肾病（idiopathic membranous nephropathy，IMN）约占到膜性肾病（MN）的75%，其病理特征为免疫复合物的沉积，导致肾小球基底膜增厚，滤过屏障损伤，最终可能发展为终末期肾脏病。血清抗M型磷脂酶A2受体（phospholipase A2 receptor，PLA2R）是IMN的特异性标志物，其诊断敏感性为70%～80%，特异性高达95%以上。本综述主要是阐述PLA2R抗体对于特发性膜性肾病的诊断价值，其抗体滴度、动态监测在疾病治疗过程中的意义及对预后的评估、复发可能性的预判，从而对PLA2R有更加直观的认识，更好的指导临床工作。

关键词


M型磷脂酶A2受体；特发性膜性肾病；诊断；治疗；预后

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参考


[1]Xuexia Li. Immune Regulatory Effects of Sinomenine on Primary Membranous Nephropathy: Based on Case Report and Network Pharmacology. HSOA journal of alternative, complementary & integrative medicine. 2024;10 (3):1-7. doi:10.24966/acim-7562/100470

[2]BECK L H Jr，BONEGIO R G，LAMBEAU G，et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy[J]. N Engl J Med，2009，361（1）：11-21.

[3]李红莉，贾红红.血清抗PLA2R抗体、增殖诱导配体、24h尿蛋白水平联合检测在特发性膜性肾病中的应用价值[J].陕西医学杂志，2023，52（01）：93-96.

[4]Provatopoulou, S., Kalavrizioti, D., Stangou, M., et al. (2019) Cir-culating Anti-Phospholipase A2 Receptor Antibodies as a Diagnostic and Prognostic Marker in Greek Patients with Idi-opathic Membranous Nephropathy—A Retrospective Cohort Study. Romanian Journal of Internal Medicine, 57, 141-150.

[5]Wei SY,Wang YX,Li JS,et al.Serum Anti-PLA2R antibody predicts treatment outcome in idiopathic membranous nephropathy[J].American Journal of Nephrology,2016,43(2):129-140.

[6]RADHAKRISHNAN J，CATTRAN D C. The KDIGO practice guideline on glomerulonephritis：reading between the（guide）lines-application to the individual patient[J]. Kidney Int，2012，82（8）：840-856.

[7]Tiffany Caza,Christopher P. Larsen. False-positive anti-PLA2R ELISA testing in patients with diabetes mellitus. Kidney International. 2023;103 (2):425-425. doi:10.1016/j.kint.2022.11.004

[8]Sjoerd A.M.E.G. Timmermans,Rivka Ayalon,Pieter van Paassen, et al. Anti-Phospholipase A2 Receptor Antibodies and Malignancy in Membranous Nephropathy. American Journal of Kidney Diseases. 2013;62 (6):1223-1225. doi:10.1053/j.ajkd.2013.07.019

[9]TOMAS N M，BECK L H Jr，MEYER-SCHWESINGER C，et al. Thrombospondin type-1 domain-containing 7A in idiopathic membranous nephropathy[J]. N Engl J Med，2014，371（24）：2277-2287.

[10]HOXHA E，BECK LH Jr，WIECH T，et al. An indirect immunofluorescence method facilitates detection of thrombospondin type 1 domain-containing 7A-specific antibodies in membranous nephropathy[J]. J Am Soc Nephrol，2017，28（2）：520-531.

[11]李幼奇，刘珍珍，林克宣，等.肾组织中磷脂酶A2受体抗原的表达与特发性膜性肾病的临床及预后的关系[J].中华肾脏病杂志，2018，34（9）：661-666. DOI：10.3760/cma.j.issn.1001-7097.2018.09.004.

[12]Dhnrich C , Saschenbrecker S , Gunnarsson I ,et al.Development of a Standardized Chemiluminescence Immunoassay for the Detection of Autoantibodies Against Human M-Type Phospholipase A2 Receptor in Primary Membranous Nephropathy[J].Kidney International Reports, 2019, 5:182 - 188.DOI:10.1016/j.ekir.2019.11.008. Shane A. Bobart,An S. De

[13]Vriese,Aditya S. Pawar, et al. Noninvasive diagnosis of primary membranous nephropathy using phospholipase A2 receptor antibodies. Kidney International. 2019;95 (2):429-438. doi:10.1016/j.kint.2018.10.021

[14]蒋真斌，蔡美顺，董葆，等.适合中国人的抗磷脂酶A2受体抗体临界值的界定[J].中华肾脏病杂志，2020，36（05）：379-384.

[15]张雪琴，姜鸿，杨淑芬，等.血清磷脂酶A2受体抗体预测利妥昔单抗治疗特发性膜性肾病疗效价值的初探[J].临床肾脏病杂志，2021，21（03）：206-209.

[16]Rovin B, Adler S, Barratt J et al (2021) KDIGO 2021 clinicalpractice guideline for the management of glomerular diseases.domised controlled trial. The Lancet 381:744-751. https://doi.org/10.1016/s0140-6736(12)61566-9Kidney Int 100:S1-S276.

[17]Stamatia Stai,Georgios Lioulios,Michalis Christodoulou, et al. From KDIGO 2012 towards KDIGO 2021 in idiopathic membranous nephropathy guidelines: what has changed over the last 10 years?[J]. Journal of Nephrology, 2022, 36: 551-561.

[18]蒋秋艳.探讨抗PLA2R抗体在特发性膜性肾病治疗中的临床价值[D].广西中医药大学，2022.DOI：10.27879/d.cnki.ggxzy.2021.000332.

[19]胡广.血清抗PLA2R抗体在特发性膜性肾病诊断及病情评估中应用的可行性分析[D].广西中医药大学，2020

[20]Qin, Congcong MMa,b; Hu, Zhijuan MDb,*; Shi, Yanan MMb; Cui, Hui MMb,c; Li, Jiejie MMb,d. Two successful pregnancies in a membranous nephropathy patient: Case report and literature review. Medicine 103(6):p e37111, February 09, 2024. | DOI: 10.1097/MD.0000000000037111

[21]Ramachandran R , Yadav A K , Kumar V ,et al.Temporal Association Between PLA2R Antibodies and Clinical Outcomes in Primary Membranous Nephropathy[J].Kidney International Reports, 2017:S246802491730387X.DOI:10.1016/j.ekir.2017.09.001.

[22]Christine B , Willcocks L C , Jones R B ,et al.Effect of belimumab on proteinuria and anti-phospholipase A2 receptor autoantibody in primary membranous nephropathy[J].Nephrology Dialysis Transplantation, 2019.DOI:10.1093/ndt/gfz086.

[23]Chao,Hang,Yu-Bing,et al.Analysis of predictive factors for immunosuppressive response in anti-phospholipase A2 receptor antibody positive membranous nephropathy.[J].BMC Nephrology, 2018.DOI:10.1186/s12882-018-1160-6.

[24]张莹莹，郭彦聪.成人IMN患者PLA2R抗体诊疗价值研究近况_张莹莹[J].中国医学创新，2023，20（11）：173-178.

[25]王慧，江嫚，张迪，等.M型磷脂酶A2受体与膜性肾病的临床诊治_进展与争议_王慧[J].临床肾脏病杂志，2021，21（01）：68-73.

[26]包娜娜，郝丽荣.PLA2R和IgG在特发性膜性肾病的表达及意义[J].中国中西医结合肾病杂志，2023，24（12）：1099-1101+1144.


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