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Modern Pathology
Article . 2016 . Peer-reviewed
License: CC BY NC ND
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Modern Pathology
Article
License: CC BY NC ND
Data sources: UnpayWall
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PubMed Central
Article . 2016
License: CC BY NC ND
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Modern Pathology
Article . 2017
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THSD7A staining of membranous glomerulopathy in clinical practice reveals cases with dual autoantibody positivity

Authors: Larsen, Christopher P; Cossey, L Nicholas; Beck, Laurence H;

THSD7A staining of membranous glomerulopathy in clinical practice reveals cases with dual autoantibody positivity

Abstract

Thrombospondin type I domain-containing 7A (THSD7A) is a known antigenic target of autoantibodies leading to primary membranous glomerulopathy and was reported to account for ~10% of phospholipase A2 receptor (PLA2R)-negative membranous glomerulopathy. It has been proposed that PLA2R and THSD7A autoantibodies are mutually exclusive in membranous glomerulopathy. We validated an immunohistochemical assay to investigate for THSD7A-associated membranous glomerulopathy and utilized it in 258 consecutive native kidney biopsies, which showed membranous glomerulopathy in our laboratory, with the exception of membranous lupus nephritis. Membranous glomerulopathy stained positive for THSD7A-only in 7 (3%) cases, PLA2R-only in 141 (55%) cases, and showed dual positivity for THSD7A and PLA2R in 2 (1%) cases. Serologic testing for antibodies to PLA2R and THSD7A was performed in a subset of these patients. There was 100% correlation between positive THSD7A and/or PLA2R tissue staining and the presence of the corresponding autoantibodies in the serum including the two cases with dual positive THSD7A and PLA2R antibodies. We describe and provide a protocol for detection of THSD7A-associated membranous glomerulopathy in clinical practice. The cases with dual THSD7A and PLA2R positivity show that these autoantibodies are not mutually exclusive. They also emphasize the importance of using a panel-based approach when subtyping membranous glomerulopathy as a patient could conceptually be identified and treated based on anti-PLA2R titers, but still have anti-THSD7A antibodies driving persistent disease.

Related Organizations
Keywords

Adult, Male, Staining and Labeling, Receptors, Phospholipase A2, Blotting, Western, Middle Aged, Autoantigens, Glomerulonephritis, Membranous, Immunohistochemistry, Humans, Original Article, Female, Thrombospondins, Aged, Autoantibodies

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    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
90
Top 1%
Top 10%
Top 1%
Green
hybrid