The Clinical Significance Of Serum Antibodies Of PLA2R And THSD7A In Idiopathic Membranous Nephropathy

Objective: In recent years,studies have shown that M-type phospholipase A2 receptor and Thrombospondin type-1 domain-containing 7A are the main Pathogenic target antigens for idiopathic membranous nephropathy(IMN),antigens deposition in renal tissue and serological specificity antibody are closely associated with disease.The renal biopsy is an gold standard of diagnostic IMN,but it is an invasive operation,it is inconvenient to observe the disease dynamically,Instead,it is easier to detect PLA2 R and THSD7 A antibody in serum.The aim of this study is to explore the significance of both the IMN diagnosis and the evaluation of the disease by detecting the serum PLA2 R and THSD7 A antibody levels in IMN patients.Method: A total of 137 patients who were diagnosed with renal biopsy in the third hospital of Hebei medical university from September 2016 to December 2017 were selected.Among them,114 patients with IMN were treated as experimental group,and 23 others,including(7 patients of V-type lupus nephritis and 16 cases of IgA nephropathy)as control group.The serum PLA2 R and THSD7 A antibody titer were determined by enzyme-linked immuno sorbent assay(ELISA),then analyze the relationship between with clinical indicators.Results:1.The positive rate of serum PLA2 R antibody in IMN patients is 57.0%(65/114).V-type lupus nephritis and IgA nephropathy positive rate is 0%,the difference has statistically significant(P < 0.05).The positive rate of serum THSD7 A antibody in IMN patients is 9.6%(11/114),V-type with lupus nephritis and IgA nephropathy THSD7 A antibody positive rate is 0%,the difference has statistically significant.The double positive rate in IMN group is 4.4%(5/114).2.In the IMN group,24 h urine protein is quantitatively(9.4±4.1)g/d and blood albumin(21.2±3.7)g/L.PLA2 R antibody positive 24 h urine protein quantification [4.9(0.9-14.2)] g/d,blood albumin(24.4±5.6)g/L;The serum albumin(25.5±6.6)g/L is found in patients with positive THSD7 A antibody(7.1±4.1)g/d.The results showed that there are statistically significant differences between the serum albumin and the serum albumin(P<0.05).There is no statistical significance in the quantitative difference of 24 h urine protein in patients with positive THSD7 A antibody(P>0.05),and the difference in blood albumin is statistically significant(P < 0.05).3.There is a positive correlation between PLA2 R antibody and 24 h urine protein(r=0.318,P=0.001),which is negatively correlated with serum albumin level(r=-0.207,P=0.027).Conclusions:PLA2R and THSD7 A antibody are specific indicators for the diagnosis of IMN.PLA2 R antibody can assess the patient's condition;High urinary protein and low albumin in patients with double antibody positive;However,whether THSD7 A can assess the patient's condition and whether the combination can better predict the patient's condition remains to be further studied.