Three possible reasons might contribute to the discrepancy

Three possible reasons might contribute to the discrepancy. relationship between IF predominance of glomerular IgG subtype and electron microscopic (EM) stages of IMN. Results We did not find statistical difference of predominant or codominant rate (pre/co-rate) among EM stages in any subclass (> 0.05). Pre/co-rate of IgG3 linearly associated with EM stage in total and PLA2R-related subgroup (= 0.044, = 0.013). PLA2R-related subgroup showed higher IgG4 intensity (2.1 0.6 vs. 1.6 0.7, = 0.001) and pre/co-rate of IgG4 in stage 1 (97% vs. 57%, = 0.015) than PLA2R-unrelated group. We found no difference of IgG subclass pre/co-rate in different EM stages or linear association between pre/co-rate of IgG1, IgG2, IgG4, and EM stages (> 0.05). Conclusions Pre/co-rate of IgG3 declined with EM stage in total and PLA2R-related subgroup. We did not find IgG subclass switches from IgG1 to IgG4 in either IMN patients or subgroups. 1. Introduction Idiopathic membranous nephropathy (IMN) is usually a leading cause of nephrotic syndrome among the adult populace [1, 2]. M-type phospholipase A2 receptor (PLA2R), the dominant autoantigen of IMN with mostly specific IgG4 autoantibodies, has been analyzed widely since discovered in 2009 2009 [3]. The exact role of different IgG subclass in IMN remained elusive. In 2013, Huang et al. examined pathological data in 157 membranous nephropathy patients. They implied major IgG subtype deposited in glomerular changed from IgG1 to IgG4 during the process of IMN [4]. However, the IgG subclass switching was observed in some but not all studies. Hihara et al. suggested IgG1 might dominate in situ while anti-PLA2R antibody was not shown by analyzing a small group of PLA2R-related IMN [5]. In 2016, Kattah et al. revealed IgG4 predominate in 5 recurrent PLA2R-related IMN and declared no subclass switch [6]. Huang et al. failed to test circulating antibody or glomerular antigen of IMN. It was unclear whether the IgG subtype switching was present in subgroup stratified by different antigen. In this study, we investigated the IgG subclass distribution of PLA2R-related and PLA2R-unrelated IMN in different EM stages. Dihydroethidium To verify the IgG subclass switching in IMN, we illustrate the profile of IgG subtype in IMN and further investigate the IgG subclass switching in PLA2R-related and PLA2R-unrelated IMN. 2. Materials and Methods 2.1. Study Population Our study retrospectively enrolled 157 Dihydroethidium patients with biopsy-proven IMN hospitalized in the Peking Union Medical College Hospital (PUMCH) between September 2017 and Dihydroethidium November 2019. The study was approved by the PUMCH ethical committees (No. S-K014). The inclusion criteria were as follows: diagnosis of IMN confirmed by renal biopsy; serum anti-PLA2R antibody was detected at the time of diagnosis. Patients with known secondary MN, such as hepatitis B/C computer virus infection, drug/toxin exposure, autoimmune disease, or malignancy, were excluded (Physique 1). We collected clinical data from medical records at the time of diagnosis, including age at biopsy, gender, serum creatinine (Scr), albumin (Alb), and 24h urine protein (24hUP). Open in a separate windows Physique 1 Circulation diagram showing patients included in this study. 2.2. Detection of Circulating Anti-PLA2R Ab We collected Dihydroethidium the serum for anti-PLA2R antibody assay before treatment and performed with enzyme linked immunosorbent assay (ELISA) kit (EUROIMMUN, Lbeck, Germany) according to the manufacturer’s training. We set up the cut-off value of the positive result as above 14 relative light models per milliliter (RU/mL). 2.3. Kidney Biopsy We conducted standard kidney biopsy [7, 8]. Tissue for light microscopy was routinely stained with hematoxylin and eosin, Masson, Jones methenamine silver, and periodic acid-Schiff reagent. Specimen for immunofluorescence (IF) was slice at 5?test was performed for comparison between two subgroups of continuous variables. Differences in categorical variables were analyzed using the Chi-squared test or Fisher’s exact when appropriate. Styles were explored by linear-by-linear association test. All tests were two-sided and values < 0.05 were considered statistically significant. Statistical analyses were performed by the SPSS statistical software package, version 20.0 (SPSS Inc., Chicago, IL). 3. Results Rabbit Polyclonal to NDUFB10 3.1. Clinical and Pathological Characteristics of.