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Title:
Expression and Significance of PLA2R, THSD7A, and IgG4 in Idiopathic Membranous Nephropathy
Authors:  Shufang Wu, M.M., Haishan Xu, M.M., Danhua Lin, B.M., and Lantao Dai, B.M.
  Objective: To investigate the expression of M-type phospholipase A2 receptor (PLA2R), type I thrombospondin 7A domain (THSD7A), immunoglobulin subtype (IgG4) in the renal tissue, as well as the expression levels and clinical significance of serum anti-PLA2R antibody and anti-THSD7A antibody in idiopathic membranous nephropathy (IMN).
Study Design:
A total of 32 patients with IMN, 32 patients with secondary membranous nephropathy (SMN), and 32 patients with minimal change nephropathy/disease (MCD) who were diagnosed by renal biopsy and admitted to the Department of Nephrology of the Affiliated Hospital of Putian University were selected. Quantum dot fluorescence quantitative method and indirect immunofluorescence method were used to detect the titer levels of anti-PLA2R antibody (PLA2R-Ab) and anti-THSD7A antibody (THSD7A-Ab) in serum. Immunofluorescence method and immunohistochemistry method were used to detect the expression of glomerular PLA2R, THSD7A, and IgG4 and to verify the clinical data of each group.
Results:
The serum PLA2R-Ab level and the positive rate of patients in the IMN group were significantly higher than those in the SMN and MCD groups. PLA2R-Ab level was positively correlated with 24-hour urinary protein quantity and negatively correlated with serum albumin level. In addition, immunofluorescence expression intensity and positive rate of glomerular PLA2R, THSD7A, and IgG4 in the IMN group were notably higher than those in the SMN and MCD groups. Since the detection data of THSD7A-Ab was lower than the detective limit of the kit, no positive expression was detected.
Conclusion:
The detection of serum PLA2R-Ab and glomerular PLA2R, THSD7A, and IgG4 levels was of high value to the clinical diagnosis of IMN for adults and can be used for the differential diagnosis of diseases.
Keywords:  IgG4, kidney disease, membranous nephropathy, nephrotic syndrome, PLA2R, THSD7A
   
   
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