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Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy

The discovery of anti-podocyte antibodies in primary membranous nephropathy (MN) has revolutionized our approach toward the diagnosis and treatment of this disease. Evaluation of serum levels of anti-podocyte antibodies paved the way for non-invasive diagnosis and helped distinguish between primary...

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Autores principales: Tesar, Vladimir, Hruskova, Zdenka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019786/
https://www.ncbi.nlm.nih.gov/pubmed/33828546
http://dx.doi.org/10.3389/fimmu.2021.593288
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author Tesar, Vladimir
Hruskova, Zdenka
author_facet Tesar, Vladimir
Hruskova, Zdenka
author_sort Tesar, Vladimir
collection PubMed
description The discovery of anti-podocyte antibodies in primary membranous nephropathy (MN) has revolutionized our approach toward the diagnosis and treatment of this disease. Evaluation of serum levels of anti-podocyte antibodies paved the way for non-invasive diagnosis and helped distinguish between primary and secondary MN although the relationship between anti-podocyte antibodies and cancer remains to be elucidated. Serum levels of anti-PLA2R antibodies directed against the major podocyte autoantigen are related to MN activity and the decrease in serum levels of anti-PLA2R antibodies in response to treatment (immunologic remission) also serves as an early indicator of the later putative proteinuric remission, enabling personalization of the treatment. The serum levels of anti-podocyte antibodies also enable the prediction of renal outcomes in terms of both remission and the risk of progression to end-stage renal disease. The positivity of anti-PLA2R antibodies before renal transplantation is associated with the risk of recurrence of MN. It remains to be established if all these relations observed in patients with anti-PLA2R antibodies are also valid for expanding spectrum of antibodies directed against recently discovered minor antigens (e.g., THSD7A, NELL-1, semaphorin 3B).
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spelling pubmed-80197862021-04-06 Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy Tesar, Vladimir Hruskova, Zdenka Front Immunol Immunology The discovery of anti-podocyte antibodies in primary membranous nephropathy (MN) has revolutionized our approach toward the diagnosis and treatment of this disease. Evaluation of serum levels of anti-podocyte antibodies paved the way for non-invasive diagnosis and helped distinguish between primary and secondary MN although the relationship between anti-podocyte antibodies and cancer remains to be elucidated. Serum levels of anti-PLA2R antibodies directed against the major podocyte autoantigen are related to MN activity and the decrease in serum levels of anti-PLA2R antibodies in response to treatment (immunologic remission) also serves as an early indicator of the later putative proteinuric remission, enabling personalization of the treatment. The serum levels of anti-podocyte antibodies also enable the prediction of renal outcomes in terms of both remission and the risk of progression to end-stage renal disease. The positivity of anti-PLA2R antibodies before renal transplantation is associated with the risk of recurrence of MN. It remains to be established if all these relations observed in patients with anti-PLA2R antibodies are also valid for expanding spectrum of antibodies directed against recently discovered minor antigens (e.g., THSD7A, NELL-1, semaphorin 3B). Frontiers Media S.A. 2021-03-22 /pmc/articles/PMC8019786/ /pubmed/33828546 http://dx.doi.org/10.3389/fimmu.2021.593288 Text en Copyright © 2021 Tesar and Hruskova. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Tesar, Vladimir
Hruskova, Zdenka
Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy
title Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy
title_full Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy
title_fullStr Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy
title_full_unstemmed Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy
title_short Autoantibodies in the Diagnosis, Monitoring, and Treatment of Membranous Nephropathy
title_sort autoantibodies in the diagnosis, monitoring, and treatment of membranous nephropathy
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019786/
https://www.ncbi.nlm.nih.gov/pubmed/33828546
http://dx.doi.org/10.3389/fimmu.2021.593288
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