Diagnostic performance of glomerular PLA2R and THSD7A antibodies in biopsy confirmed primary membranous nephropathy in South Africans

dc.contributor.authorLwezaula, Bingileki F
dc.contributor.authorAmeh, Oluwatoyin I
dc.contributor.authorEkrikpo, Udeme E
dc.contributor.authorBotha, Francois C
dc.contributor.authorOkpechi-Samuel, Ugochi S
dc.contributor.authorWearne, Nicola
dc.contributor.authorRonco, Pierre
dc.contributor.authorBello, Aminu K
dc.contributor.authorOkpechi, Ikechi G
dc.date.accessioned2021-06-29T20:04:34Z
dc.date.available2021-06-29T20:04:34Z
dc.date.issued2021-01-07
dc.date.updated2021-01-10T04:12:35Z
dc.description.abstractBackground: Serum and tissue-based tests using phospholipase A2 receptor 1 (PLA2R) and thrombospondin type-1 domain containing 7A (THSD7A) are established immune biomarkers for the diagnosis of primary membranous nephropathy (PMN). This study assessed the diagnostic performance of these biomarkers in the diagnosis of PMN in South Africans. Methods This was a cross-sectional analysis from a single centre in Cape Town, South Africa. Relevant biodata was collected from all patients. Histology, including slides for PLA2R and THSD7A were processed and assessed by typical microscopic and immunohistochemical features. Biopsy tissues of patients with membranous lupus nephritis (LN-V) and diabetic nephropathy (DN) were used as controls. The diagnostic accuracy for diagnosis of PMN using positive PLA2R and THSD7A were evaluated. Results Of the 88 patients included, 41 had PMN with a mean age of 44.5 ± 17.5 years and 61.0% were female. Histologically, PLA2R and THSD7A were only positive in the PMN group (51.2% and 4.9%, respectively) but negative in both control groups. The sensitivity of PLA2R and THSD7A for identifying PMN was 51.2% and 4.9%, respectively. The sensitivity of both tests together was 53.7% while the specificity and positive predictive values (PPV) for any of the tests (alone or in combination) was 100%. There was no difference in the sensitivity and specificity when using PLA2R alone compared to combining the two tests (p=0.32). Conclusion Glomerular staining of PLA2R and THSD7A could have potential diagnostic values in South Africans. This has implications on how immunotherapies can be initiated and used in these settings.
dc.identifier.ris TY - AU - Lwezaula, Bingileki F AU - Ameh, Oluwatoyin I AU - Ekrikpo, Udeme E AU - Botha, Francois C AU - Okpechi-Samuel, Ugochi S AU - Wearne, Nicola AU - Ronco, Pierre AU - Bello, Aminu K AU - Okpechi, Ikechi G AB - Background: Serum and tissue-based tests using phospholipase A2 receptor 1 (PLA2R) and thrombospondin type-1 domain containing 7A (THSD7A) are established immune biomarkers for the diagnosis of primary membranous nephropathy (PMN). This study assessed the diagnostic performance of these biomarkers in the diagnosis of PMN in South Africans. Methods This was a cross-sectional analysis from a single centre in Cape Town, South Africa. Relevant biodata was collected from all patients. Histology, including slides for PLA2R and THSD7A were processed and assessed by typical microscopic and immunohistochemical features. Biopsy tissues of patients with membranous lupus nephritis (LN-V) and diabetic nephropathy (DN) were used as controls. The diagnostic accuracy for diagnosis of PMN using positive PLA2R and THSD7A were evaluated. Results Of the 88 patients included, 41 had PMN with a mean age of 44.5 ± 17.5 years and 61.0% were female. Histologically, PLA2R and THSD7A were only positive in the PMN group (51.2% and 4.9%, respectively) but negative in both control groups. The sensitivity of PLA2R and THSD7A for identifying PMN was 51.2% and 4.9%, respectively. The sensitivity of both tests together was 53.7% while the specificity and positive predictive values (PPV) for any of the tests (alone or in combination) was 100%. There was no difference in the sensitivity and specificity when using PLA2R alone compared to combining the two tests (p=0.32). Conclusion Glomerular staining of PLA2R and THSD7A could have potential diagnostic values in South Africans. This has implications on how immunotherapies can be initiated and used in these settings. DA - 2021-01-07 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Nephrology KW - Africans KW - Primary membranous nephropathy KW - Lupus nephritis KW - PLA2R KW - THSD7A LK - https://open.uct.ac.za PY - 2021 T1 - Diagnostic performance of glomerular PLA2R and THSD7A antibodies in biopsy confirmed primary membranous nephropathy in South Africans TI - Diagnostic performance of glomerular PLA2R and THSD7A antibodies in biopsy confirmed primary membranous nephropathy in South Africans UR - http://hdl.handle.net/11427/33420 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12882-020-02216-7
dc.identifier.urihttp://hdl.handle.net/11427/33420
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.sourceBMC Nephrology
dc.sourceBMC Nephrology
dc.source.journalissue1
dc.source.journalvolume22
dc.source.pagination15
dc.source.urihttps://bmcnephrol.biomedcentral.com/
dc.subjectAfricans
dc.subjectPrimary membranous nephropathy
dc.subjectLupus nephritis
dc.subjectPLA2R
dc.subjectTHSD7A
dc.titleDiagnostic performance of glomerular PLA2R and THSD7A antibodies in biopsy confirmed primary membranous nephropathy in South Africans
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