ArticleJournal of the American Society of Nephrology : JASN2016
Epitope Spreading of Autoantibody Response to PLA2R Associates with Poor Prognosis in Membranous Nephropathy.
Article in Journal of the American Society of Nephrology : JASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
115 citing papers in PubMed, 2 syntheses or guidelines pooled it, 212 citations in OpenAlex.
- Single-nucleotide polymorphism rs4664308 in PLA2R1 gene is associated with the risk of idiopathic membranous nephropathy: a meta-analysis.Scientific reports · 2020Pooled it
- Pooled it
- Autoantigens PLA2R and THSD7A in membranous nephropathy share a common epitope motif in the N-terminal domain.Journal of autoimmunity · 2020Trial
- High-Dose Rituximab and Early Remission in PLA2R1-Related Membranous Nephropathy.Clinical journal of the American Society of Nephrology : CJASN · 2019Trial
- Phospholipase A2 Receptor 1 Epitope Spreading at Baseline Predicts Reduced Likelihood of Remission of Membranous Nephropathy.Journal of the American Society of Nephrology : JASN · 2018Trial
- Anti-nephrin autoantibodies in post-transplant recurrence of focal segmental glomerulosclerosis: a review.Renal failure · 2026Review
- MHC class II and PLA2R investigating the epitope presentation deficits driving antibody production in membranous nephropathy.International urology and nephrology · 2026Review
- Animal models of idiopathic membranous nephropathy: Recent advances and future perspectives.Animal models and experimental medicine · 2026Review
- Research Advances in Rituximab-Resistant Membranous Nephropathy.Kidney medicine · 2026Review
- Mapping of Phospholipase A2 Receptor Epitopes in Idiopathic Membranous Nephropathy and Clinical Relevance of Epitope Profiles.Journal of the American Society of Nephrology : JASN · 2026Article
- Beyond Titers: Phospholipase A2 Receptor Epitope Complexity as a New Lens in Membranous Nephropathy.Journal of the American Society of Nephrology : JASN · 2026Article
- Recurrent, Nonrecurrent, and De Novo Membranous Nephropathy After Kidney Transplantation: A Systematic Review and Meta-Analysis.Kidney medicine · 2026Article
- Identification of antibodies against phospholipase A2 receptor peptides in PLA2R-associated membranous nephropathy with negative circulating anti-PLA2R antibodies.Frontiers in immunology · 2026Article
- Treatment strategies for rituximab-resistant primary membranous nephropathy: from resistance mechanisms to emerging therapies.Frontiers in immunology · 2026Review
- Autoimmune nodopathy associated with Sjögren's disease and nephrotic syndrome: a case report and literature review.Frontiers in immunology · 2026Review
- Contemporary review of primary membranous nephropathy.Frontiers in immunology · 2026Review
- Preclinical evaluation of antigen-specific B-cell depletion for phospholipase A2 receptor membranous nephropathy with chimeric autoantibody receptor T cells.Kidney international · 2026Article
- Immunotherapy of membranous nephropathy: strategic evolution from CD20 monoclonal antibodies to future vaccines.Frontiers in immunology · 2026Review
- The personalized approach to rituximab treatment in membranous nephropathy: a multi-center randomized controlled trial.EClinicalMedicine · 2025Article
- Impact of Time-To-Treatment on Outcomes in Autoimmune Membranous Nephropathy.Kidney international reports · 2025Article
55 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The phospholipase A2 receptor (PLA2R1) is the major autoantigen in idiopathic membranous nephropathy. However, the value of anti-PLA2R1 antibody titers in predicting patient outcomes is unknown. Here, we screened serum samples from 50 patients positive for PLA2R1 for immunoreactivity against a series of PLA2R1 deletion mutants covering the extracellular domains. We identified reactive epitopes in the cysteine-rich (CysR), C-type lectin domain 1 (CTLD1), and C-type lectin domain 7 (CTLD7) domains and confirmed the reactivity with soluble forms of each domain. We then used ELISAs to stratify 69 patients positive for PLA2R1 by serum reactivity to one or more of these domains: CysR (n=23), CysRC1 (n=14), and CysRC1C7 (n=32). Median ELISA titers measured using the full-length PLA2R1 antigens were not statistically different between subgroups. Patients with anti-CysR-restricted activity were younger (P=0.008), had less nephrotic range proteinuria (P=0.02), and exhibited a higher rate of spontaneous remission (P=0.03) and lower rates of renal failure progression (P=0.002) and ESRD (P=0.01) during follow-up. Overall, 31 of 69 patients had poor renal prognosis (urinary protein/creatinine ratio >4 g/g or eGFR<45 ml/min per 1.73 m(2) at end of follow-up). High anti-PLA2R1 activity and epitope spreading beyond the CysR epitope were independent risk factors of poor renal prognosis in multivariable Cox regression analysis. Epitope spreading during follow-up associated with disease worsening (n=3), whereas reverse spreading from a CysRC1C7 profile back to a CysR profile associated with favorable outcome (n=1). We conclude that analysis of the PLA2R1 epitope profile and spreading is a powerful tool for monitoring disease severity and stratifying patients by renal prognosis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.