Roberto Assandri ,Alessandro Montanelli ,Marta Monari ,Manuel A Podestà ,Giorgio Graziani *
Membranous Nephropathy (MN) is the leading cause of nephrotic syndrome in adults. Primary or idiopathic Membranous Nephropathy (iMN) has been considered as an organ-specific autoimmune disease with an unknown aetiology. By contrast, secondary membranous nephropathy has been described as the expression of a systemic autoimmune response to malignancy or bacterial/viral infections. In the majority of iMN cases, glomerular lesions are determined by autoantibodies against a podocyte membrane protein, the M-type of phospholipase A2 receptor 1 (PLA2R1). Several studies have suggested that the detection of anti-PLA2R1 in patients sera with nephrotic syndrome may be pathognomonic of iMN, thus obviating the need for a diagnostic renal biopsy and an extensive workup for underlying causes. Many authors inferred that the measurement of anti-PLA2R1 may change the diagnostic algorithm in patients with nephrotic syndrome and guide treatment decisions in patients with iMN. Measurement of anti-PLA2R1 antibodies is now possible through an easy to use, commercially available assay. The aim of this review is to describe the clinical relevance of anti-PLA2R1 assessment in patients with MN, and to extensively discuss the biotechnological methods available to measure them.
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