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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2016 ; 95
(37
): e4809
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HLA-DR, and not PLA2R, is expressed on the podocytes in kidney allografts in de
novo membranous nephropathy
#MMPMID27631233
Wen J
; Xie K
; Zhang M
; Chen J
; Zhang J
; Cheng D
; Li X
; Ji S
; Liu Z
Medicine (Baltimore)
2016[Sep]; 95
(37
): e4809
PMID27631233
show ga
Idiopathic membranous nephropathy (IMN) is known to be associated with antibodies
acting on the M-type phospholipase A2 receptor (PLA2R) of the podocyte. However,
the mechanism underlying de novo membranous nephropathy (dn MN)
posttransplantation remains unclear. In this study, we aimed to elucidate the
mechanism underlying dn MN.We selected 8 cases with dn MN and compared them to 20
IMN cases. Fifteen cases of stable grafts were selected as controls.Several
differences between the dn MN group and the IMN group were detected. IgG4 showed
negligible positive staining in patients with dn MN, while it was predominant in
the IMN group (1/8 vs 20/20, P?0.001). Serum anti-PLA2R antibodies and
anti-PLA2R antibodies of the podocyte were very few in the dn MN patients;
however, these antibodies were detected in most of the IMN patients (serum
anti-PLA2R antibodies: 1/8 vs 16/20, P?=?0.002, anti-PLA2R antibodies of the
podocyte: 0/8 vs 17/20, P?0.001). The dn MN patients also showed higher ratio
of interstitial inflammation, peritubular capillaritis, and peritubular capillary
C4d deposition. Importantly, human leukocyte antigens (HLA)-DR expression was
detected on the podocytes in most of the dn MN patients, but none of the IMN
patients and stable graft patients showed HLA-DR expression.These data suggested
that the PLA2R pathway, which is known to play a role in IMN, was not involved in
the mechanism underlying dn MN. On the contrary, dn MN might be associated with
the alloimmune response directed against the podocyte.