M型磷脂酶A2受体与膜性肾病的临床诊治:进展与争议

血清抗M型磷脂酶A2受体(phospholipase A2 receptor,PLA2R)抗体对特发性膜性肾病的诊断敏感性为70％～80％,特异性高达95％以上.本综述主要从PLA2R入手,阐述其在膜性肾病的发病机制、诊断、治疗、预后方面的进展,并探讨目前仍存在的一些争议:如何判定血清抗PLA2R抗体阳性以及其阳性能否...

Value of M-type phospholipase A2 receptor in clinical diagnosis and treatment of membranous nephropathy:recent advances and current controversies

The sensitivity of serum anti-M-type phospholipase A2 receptor antibodies(anti-PLA2R Abs)is 70%~80%in idiopathic membranous nephropathy and the specificity over 95%.This article reviewed the latest research advances on the pathogenesis,diagnosis,treatment and prognosis of PLA2R in membranous nephropathy(MN)and discussed some current controversies as well.The positivity of anti-PLA2R Abs was defined and whether or not positive anti-PLA2R Abs adequately excluded secondary membranous nephropathy.Also discussed were the issues of whether or not quantifying anti-PLA2R Abs predicted prognosis and determined the starting,timing and duration of immunosuppressive treatment.The relationship was examined between anti-PLA2R Abs titer and recurrent and de novo MN in transplanted kidney as well.The goal was to fully understand the significance of PLA2R in membranous nephropathy and guide clinical practices.