Association of anti-phospholipasea2-receptor antibodies with clinical course of idiopathic membranous nephropathy.

Aim of the study - assessment of the presence of M-type phospholipase A2 receptor antibodies in Georgian patients with biopsy proven IMN and their correlation with the disease activity for the appliance and monitoring of immunosuppressive therapy. A total 37 patients, after exclusion of the possible secondary factors, with biopsy proven IMN entered the study. All patients received standard immunosuppressive therapy: cyclosporine combined with methylprednisolone. There were 28 (76%) patients with PLA2R-AB positive and 9 (24%) negative (assessed as 1:<10) at baseline. Among the 28 patients under immunosuppressive therapy at month 6 in 11 of them PLA2R-AB turned negative, in 14 decreased quantitatively but were persistent positive and in 3 of them PLA2R-AB once turned negative then relapsed after withdrawn of immunosuppressive therapy. Among 11 PLA2R-AB negative patients, 9 patients got complete remission of proteinuria and the other 2 patients only partial remission. At month 12 the range of proteinuria was significantly lower in PLA2R-AB negative group than in PLA2R-AB positive group. The level of circulating PLA2R-AB in IMN patients showed correlation with disease activity. The indicators of good prognosis of IMN were negative PLA2R-AB titer at baseline and progressive decreasing of titer under the immunosuppressive therapy in PLA2R-AB positive patients. The detection and measurement of PLA2R-AB in INM patients may be important tool in monitoring of the disease and efficacy of the treatment.