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Liu X, Xue J, Li T, Wu Q, Sheng H, Yang X, Lin B, Zhou X, Qin Y, Huang Z, Zhou L, Wang L, Hu Z, Huang B. Quantitative detection and prognostic value of antibodies against M-type phospholipase A2 receptor and its cysteine-rich ricin domain and C-type lectin domains 1 and 6-7-8 in patients with idiopathic membranous nephropathy. PLoS One 2024; 19:e0298269. [PMID: 38386672 PMCID: PMC10883571 DOI: 10.1371/journal.pone.0298269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND M-type phospholipase A2 receptor (PLA2R) is the major autoantigen in adult idiopathic membranous nephropathy (IMN). Although reactive epitopes in the PLA2R domains have been identified, the clinical value of these domains recognized by anti-PLA2R antibodies remains controversial. Accordingly, this study aimed to quantitatively detect changes in the concentrations of different antibodies against epitopes of PLA2R in patients with IMN before and after treatment to evaluate the clinical value of epitope spreading. METHODS Highly sensitive time-resolved fluorescence immunoassay was used to quantitatively analyze the concentrations of specific IgG and IgG4 antibodies against PLA2R and its epitopes (CysR, CTLD1, CTLD6-7-8) in a cohort of 25 patients with PLA2R-associated membranous nephropathy (13 and 12 in the remission and non-remission groups, respectively) before and after treatment, and the results were analyzed in conjunction with clinical biochemical indicators. RESULTS The concentration of specific IgG (IgG4) antibodies against PLA2R and its epitopes (CysR, CTLD1 and CTLD6-7-8) in non-remission group was higher than that in remission group. The multipliers of elevation of IgG (IgG4) antibody were 5.6(6.2) fold, 3.0(24.3) fold, 1.6(9.0) fold, and 4.2(2.6) fold in the non-remission/remission group, respectively. However, the difference in antibody concentrations between the two groups at the end of follow-up was 5.6 (85.2), 1.7 (13.1), 1.0 (5.1), and 1.5 (22.3) times higher, respectively. When detecting concentrations of specific IgG antibodies against PLA2R and its different epitopes, the remission rate was 66.67% for only one epitope at M0 and 36.36% for three epitopes at M0. When detecting concentrations of specific IgG4 antibodies against PLA2R and its different epitopes, the remission rate was 100.00% for only one epitope at M0 and 50.00% for three epitopes at M0. A trivariate logistic regression model for the combined detection of eGFR, anti-CTLD678 IgG4, and urinary protein had an AUC of 100.00%. CONCLUSION Low concentrations of anti-CysR-IgG4, anti-CTLD1-IgG4, and anti-CTLD6-7-8-IgG4 at initial diagnosis predict rapid remission after treatment. The use of specific IgG4 against PLA2R and its different epitopes combined with eGFR and urinary protein provides a better assessment of the prognostic outcome of IMN.
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Affiliation(s)
- Xiaobin Liu
- Wuxi Medical Center, Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, China
| | - Jing Xue
- Wuxi Medical Center, Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, China
| | - Ting Li
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Qingqing Wu
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Huiming Sheng
- Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xue Yang
- Wuxi Children’s Hospital, Wuxi, China
| | - Bo Lin
- Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Xiumei Zhou
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Yuan Qin
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
| | - Zijian Huang
- School of Life Science, Westlake University, Hangzhou, China
| | - Leting Zhou
- Wuxi Medical Center, Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, China
| | - Liang Wang
- Wuxi Medical Center, Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, China
| | - Zhigang Hu
- Wuxi Medical Center, Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi, China
- Wuxi Children’s Hospital, Wuxi, China
| | - Biao Huang
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
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Wu Q, Hang C, Li T, Wang B, Qin Y, Wang Y, Zhou X, Xia P, Sheng H, Huang P, Huang B. Establishment of time-resolved fluoroimmunoassay of IgG4 based on magnetic microspheres. J Clin Lab Anal 2021; 35:e23874. [PMID: 34125973 PMCID: PMC8373317 DOI: 10.1002/jcla.23874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/17/2021] [Accepted: 05/29/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The abnormal increase in serum IgG4 level is an important clinical symptom of IgG4-related disease (IgG4-RD), and the detection of serum IgG4 level is a powerful tool for the diagnosis of IgG4-RD. This study was conducted to establish a simple and rapid immunoassay for the determination of human serum IgG4 levels. METHODS Based on the competition method, a novel immunoassay was established for the determination of human serum IgG4 using a combination of time-resolved fluoroimmunoassay (TRFIA) and magnetic microspheres. IgG4 was coupled with magnetic microspheres and competed with IgG4 in the samples to bind the Eu3+ -labeled anti-IgG4 antibody. The immunocomplex was separated and washed in a magnetic field, and the fluorescence counts were measured according to the number of dissociated europium ions. RESULTS The analytical sensitivity of IgG4-TRFIA based on magnetic microspheres was 0.006 g/L, and the detection range was 0.006-20 g/L under optimal conditions. The precision, recovery, and specificity of this immunoassay were demonstrated to be acceptable. The clinical application of IgG4-TRFIA based on magnetic microspheres was evaluated and compared with that of immunonephelometry. The results showed that the two detection methods had a good correlation, with a correlation coefficient of .9871. CONCLUSION IgG4-TRFIA based on magnetic microspheres has the advantages of high sensitivity, wide detection range, and short analysis time and has the potential to become a useful tool for the diagnosis of IgG4-RD.
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Affiliation(s)
- Qingqing Wu
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
| | - Chen Hang
- Tong Ren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Ting Li
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
| | - Binrong Wang
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
| | - Yuan Qin
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
| | - Yigang Wang
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
| | - Xiumei Zhou
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
| | - Pengguo Xia
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
- College of PharmacyZhejiang Chinese Medical UniversityHangzhouChina
| | - Huiming Sheng
- Tong Ren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Pei Huang
- Department of OncologyWuxi No. 2 Hospital Affiliated to Nanjing Medical UniversityWuxiChina
| | - Biao Huang
- College of Life Sciences and MedicineZhejiang Sci‐Tech UniversityHangzhouChina
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